Sebastian Luis Collazo, MSOTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

46TR00803100 Issued in NJ

Practice address

875 Route 73 N Ste B
Marlton, NJ 08053-1273

Phone

(856) 985-3336

NPI assigned

Jan 4, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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

{
    "created_epoch": "1672790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1144933110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 PARK AVE FL 1",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081083076",
            "telephone_number": "609-477-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 ROUTE 73 N STE B",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531273",
            "telephone_number": "856-985-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLAZO",
        "first_name": "SEBASTIAN",
        "middle_name": "LUIS",
        "credential": "MSOTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-04",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00803100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neil M Cohen, M.D.
• Erika V Colbert, NP
• Cole Vision Corporation
• Grace Coleman, PT, DPT
• Jovan Coleman, LAC
• Kristina Colletti, LPC, LMHC, NCC
• Gerard A. Collins, DPM
• Danielle Coluccio, PSYD
• Comfort Hands
• Comfort Hands Home Care

• Occupational Therapist in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.