Active NPI
Mary R Gallagher, OT
- Occupational Therapist
- Farmington, CT
National Provider Identifier
1073779864
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 002071
- Practice address
- 230 Farmington Ave
Farmington, CT 06032-1916 - Phone
- (860) 674-1824
- Fax
- (860) 674-1836
- NPI assigned
- Aug 1, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 002071 | CT | |
| Occupational Therapist | 225X00000X | 002071 | CT | Primary |
Addresses
Primary practice location
230 Farmington Ave
Farmington, CT 06032-1916
Mailing address
3396 E Main St
Waterbury, CT 06705-3812
Phone (203) 754-2161
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 |
|---|---|---|---|
| 002071 | CT | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1217548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1390262400000",
"number": "1073779864",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3396 E MAIN ST",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067053812",
"telephone_number": "203-754-2161",
"fax_number": "203-759-7359"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 FARMINGTON AVE",
"city": "FARMINGTON",
"state": "CT",
"postal_code": "060321916",
"telephone_number": "860-674-1824",
"fax_number": "860-674-1836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLAGHER",
"first_name": "MARY",
"middle_name": "R",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-08-01",
"last_updated": "2014-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "CT",
"license": "002071",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CT",
"license": "002071",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Farmington, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.