Kirsta R Malone, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

006107-1 Issued in NY

Practice address

Mandel Therapy Group
8842 Route 90
King Ferry, NY 13081

Phone

(315) 364-7570

Fax

(315) 364-8016

NPI assigned

Jul 2, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Kirsta Roemmelt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154528289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 KINGS CORNERS RD",
            "city": "UNION SPRINGS",
            "state": "NY",
            "postal_code": "131603193",
            "telephone_number": "315-364-8843",
            "fax_number": "315-364-8016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MANDEL THERAPY GROUP",
            "address_2": "8842 ROUTE 90",
            "city": "KING FERRY",
            "state": "NY",
            "postal_code": "13081",
            "telephone_number": "315-364-7570",
            "fax_number": "315-364-8016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "KIRSTA",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "006107-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIRSTA",
            "last_name": "ROEMMELT",
            "prefix": "MISS",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Robert Maurice Godbout, MHC
• Angela Grant-Cerasaro, MS, CCC, SLP
• Libby Danielle Kershner, OTR
• Thomas J Laclair, OTR
• Lifespan PT OT &SLP Services PLLC
• Mandel Therapy Group
• Dana E Mandel, PT, PCS
• Amber Lee Martin, OTR/L
• Margaret Martin, PT
• Anne Mills

• All providers in King Ferry, NY
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.