Individual provider Active NPI

Eleanor Jeannette Ryan, OTR/L

  • Occupational Therapist
  • Massapequa Park, NY
National Provider Identifier
1124399217
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
7297911 Issued in NY
Practice address
1130 Lakeshore Dr
Massapequa Park, NY 11762-2054
Phone
(516) 798-0097
NPI assigned
Jan 20, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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 7297911 NY Primary

Addresses

Primary practice location

1130 Lakeshore Dr
Massapequa Park, NY 11762-2054

Mailing address

1130 Lakeshore Dr
Massapequa Park, NY 11762-2054
Phone (516) 798-0097

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
7297911NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1327017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1124399217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 LAKESHORE DR",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117622054",
            "telephone_number": "516-798-0097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 LAKESHORE DR",
            "city": "MASSAPEQUA PARK",
            "state": "NY",
            "postal_code": "117622054",
            "telephone_number": "516-798-0097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "ELEANOR",
        "middle_name": "JEANNETTE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-20",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "7297911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; 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.