Active NPI
Patricia L Conrad, COTA
- Occupational Therapy Assistant
- Blooming Grove, NY
National Provider Identifier
1063795433
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 007648-1
- Practice address
- 145 Tuthill Rd
Blooming Grove, NY 10914-0173 - Phone
- (845) 496-2446
- NPI assigned
- Sep 22, 2011
- 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 Therapy Assistant | 224Z00000X | 007648-1 | NY | Primary |
Addresses
Primary practice location
145 Tuthill Rd
Blooming Grove, NY 10914-0173
Mailing address
PO Box 173
Blooming Grove, NY 10914-0173
Phone (845) 496-2446
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007648-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316649600000",
"number": "1063795433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 173",
"city": "BLOOMING GROVE",
"state": "NY",
"postal_code": "109140173",
"telephone_number": "845-496-2446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 TUTHILL RD",
"city": "BLOOMING GROVE",
"state": "NY",
"postal_code": "109140173",
"telephone_number": "845-496-2446"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONRAD",
"first_name": "PATRICIA",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-22",
"last_updated": "2011-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "007648-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blooming Grove, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.