Active NPI
Eleanor Iacovetta
- Occupational Therapy Assistant
- New City, NY
National Provider Identifier
1093023913
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 005021-1
- Practice address
- 48A Burda Ave
New City, NY 10956-1420 - Phone
- (845) 638-9103
- NPI assigned
- Sep 14, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 005021-1 | NY | Primary |
Addresses
Primary practice location
48A Burda Ave
New City, NY 10956-1420
Mailing address
48A Burda Ave
New City, NY 10956-1420
Phone (845) 638-9103
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 |
|---|---|---|---|
| 005021-1 | NY | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284422400000",
"number": "1093023913",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48A BURDA AVE",
"city": "NEW CITY",
"state": "NY",
"postal_code": "109561420",
"telephone_number": "845-638-9103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "48A BURDA AVE",
"city": "NEW CITY",
"state": "NY",
"postal_code": "109561420",
"telephone_number": "845-638-9103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IACOVETTA",
"first_name": "ELEANOR",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-09-14",
"last_updated": "2010-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "005021-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.