Individual provider Active NPI

Regan Samona Tuccillo, MS OTR/L

  • Occupational Therapist
  • Garden City, NY
National Provider Identifier
1063961175
Registry record updated Sep 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
019925-1 Issued in NY
Practice address
800 E Gate Blvd
Garden City, NY 11530-2105
Phone
(516) 745-8050
NPI assigned
Sep 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 019925-1 NY Primary

Addresses

Primary practice location

800 E Gate Blvd
Garden City, NY 11530-2105

Mailing address

1944 Stuyvesant Ave
East Meadow, NY 11554-4048
Phone (516) 353-7524

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
019925-1NYMDClinical Social Worker
019925NYMDPhysician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475193600000",
    "number": "1063961175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1944 STUYVESANT AVE",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115544048",
            "telephone_number": "516-353-7524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E GATE BLVD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115302105",
            "telephone_number": "516-745-8050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCCILLO",
        "first_name": "REGAN",
        "middle_name": "SAMONA",
        "name_prefix": "Ms.",
        "credential": "MS OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-30",
        "last_updated": "2016-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "019925-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.