Individual provider Active NPI

Donna Stefano, OTR

  • Occupational Therapist
  • Glastonbury, CT
National Provider Identifier
1073735452
Registry record updated Oct 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
002485 Issued in CT
Practice address
255 Williams St E
Glastonbury, CT 06033-2301
Phone
(860) 657-9454
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 1812 MA
Occupational Therapist 225X00000X 002485 CT Primary

Addresses

Primary practice location

255 Williams St E
Glastonbury, CT 06033-2301

Mailing address

20 Northview Dr
Glastonbury, CT 06033-3614
Phone (860) 657-2133

Other practice location 1

42 Winter St
Pembroke, MA 02359-4958
Phone (781) 335-6663

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

LicenseStateTypeSpecialty
002485CTMDClinical Social Worker
1812MAMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1073735452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 NORTHVIEW DR",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060333614",
            "telephone_number": "860-657-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 WILLIAMS ST E",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332301",
            "telephone_number": "860-657-9454"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42 Winter St",
            "address_purpose": "LOCATION",
            "city": "Pembroke",
            "state": "MA",
            "postal_code": "023594958",
            "country_code": "US",
            "telephone_number": "781-335-6663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEFANO",
        "first_name": "DONNA",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "1812",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "002485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; 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.