Active NPI
Georgia Mauceri, OTR/L
- Occupational Therapist
- Brentwood, NY
National Provider Identifier
1124869045
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 029197
- Practice address
- 52 3Rd Ave
Brentwood, NY 11717-4651 - Phone
- (631) 434-2123
- NPI assigned
- Jun 4, 2024
- 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 Therapist | 225X00000X | 029197 | NY | Primary |
Addresses
Primary practice location
52 3Rd Ave
Brentwood, NY 11717-4651
Mailing address
25 Madeley Lane
Stony Brook, NY 11790-2822
Phone (631) 741-4502
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 |
|---|---|---|---|
| 029197 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717459200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717545600000",
"number": "1124869045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 MADELEY LANE",
"city": "STONY BROOK",
"state": "NY",
"postal_code": "117902822",
"telephone_number": "631-741-4502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "52 3RD AVE",
"city": "BRENTWOOD",
"state": "NY",
"postal_code": "117174651",
"telephone_number": "631-434-2123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAUCERI",
"first_name": "GEORGIA",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-06-04",
"last_updated": "2024-06-05",
"certification_date": "2024-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "NY",
"license": "029197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brentwood, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.