Active NPI
Bridget Kavanagh, OTR
- Occupational Therapist
- Port Washington, NY
National Provider Identifier
1063011138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 300 E Overlook
Port Washington, NY 11050-4730 - Phone
- (631) 617-3218
- NPI assigned
- Oct 20, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
300 E Overlook
Port Washington, NY 11050-4730
Mailing address
43 Hollins LN
East Islip, NY 11730-3005
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 023385 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603152000000",
"number": "1063011138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 HOLLINS LN",
"city": "EAST ISLIP",
"state": "NY",
"postal_code": "117303005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 E OVERLOOK",
"city": "PORT WASHINGTON",
"state": "NY",
"postal_code": "110504730",
"telephone_number": "631-617-3218"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAVANAGH",
"first_name": "BRIDGET",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-10-20",
"last_updated": "2020-10-20",
"certification_date": "2020-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Washington, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.