Active NPI
Rae Mannino, OT
- Occupational Therapist
- Cos Cob, CT
National Provider Identifier
1154619716
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 015452-1
- Practice address
- 35 River Rd
Cos Cob, CT 06807-2759 - Phone
- (203) 422-0679
- Fax
- (203) 422-0931
- NPI assigned
- Jul 18, 2011
- Last updated
- Nov 8, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 015452-1 | NY | Primary |
| Occupational Therapist | 225X00000X | 3873 | CT |
Addresses
Primary practice location
35 River Rd
Cos Cob, CT 06807-2759
Mailing address
35 River Rd
Cos Cob, CT 06807-2759
Phone (203) 422-0679
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3873 | CT | MD | Clinical Neuropsychologist |
| 015452 | NY | MD | Physical Therapist |
| 015452-1 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Sos PT PC | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383868800000",
"number": "1154619716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 RIVER RD",
"city": "COS COB",
"state": "CT",
"postal_code": "068072759",
"telephone_number": "203-422-0679",
"fax_number": "203-422-0931"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 RIVER RD",
"city": "COS COB",
"state": "CT",
"postal_code": "068072759",
"telephone_number": "203-422-0679",
"fax_number": "203-422-0931"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNINO",
"first_name": "RAE",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-18",
"last_updated": "2013-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "015452-1",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CT",
"license": "3873",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cos Cob, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.