Active NPI
Debora Mottahedeh, D.O.
- Physical Medicine & Rehabilitation Physician
- Westbury, NY
National Provider Identifier
1154581122
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Medicine & Rehabilitation Physician
- License
- 248391-1
- Practice address
- 761 Merrick Ave
Westbury, NY 11590-6608 - Phone
- (516) 357-8777
- Fax
- (516) 357-0087
- NPI assigned
- Jun 13, 2008
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | 248391-1 | NY | Primary |
Addresses
Primary practice location
761 Merrick Ave
Westbury, NY 11590-6608
Mailing address
18 Crabapple Rd
Manhasset, NY 11030
Phone (516) 661-3631
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)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 248391-1 | NY | MD | Physical Medicine & Rehabilitation Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383523200000",
"number": "1154581122",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 CRABAPPLE RD",
"city": "MANHASSET",
"state": "NY",
"postal_code": "11030",
"telephone_number": "516-661-3631"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "761 MERRICK AVE",
"city": "WESTBURY",
"state": "NY",
"postal_code": "115906608",
"telephone_number": "516-357-8777",
"fax_number": "516-357-0087"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOTTAHEDEH",
"first_name": "DEBORA",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-13",
"last_updated": "2013-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "NY",
"license": "248391-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westbury, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.