Telisa T Wardlaw, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

016130-1 Issued in NY

Practice address

220-28 147TH Avenue
Rosedale, NY 11413

Phone

(718) 276-1600

NPI assigned

Dec 28, 2006

Sex

Female

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

Not listed in the public Medicare enrollment file

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.

• Core Therapy Services PT OT PLLC

  • Occupational Therapist
  • Brooklyn, NY
  • NPI 1679217368
  NPD
• Dynamic Physical Therapy Rehab of Ny P.C.

  • Physical Therapy Clinic/Center
  • Mineola, NY
  • NPI 1134775174
  NPD

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1164588158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17030 130TH AVE",
            "address_2": "APT 13A",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114346002",
            "telephone_number": "917-650-1126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220-28 147TH AVENUE",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "11413",
            "telephone_number": "718-276-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARDLAW",
        "first_name": "TELISA",
        "middle_name": "T",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-28",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "016130-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raquel Wallace-Griffiths
• Diane Walters
• Nola Walters
• Jaime Ward, OTR
• Martha Ward, RN
• Stephanie Karen Warren, PHYSICIAN ASSISTANT
• Felicia Washington-Brown, CNM
• Charmaine Webster, CNA
• Welllife Network Inc
• Mical White-Huffstead

• Occupational Therapist in Rosedale, NY
• Providers in Rosedale, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; 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.