Individual provider Active NPI

Donna Noel Lick, OTR

  • Occupational Therapist
  • Teaneck, NJ
National Provider Identifier
1174827547
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
46TR00453600 Issued in NJ
Practice address
206 Lindbergh Blvd
Teaneck, NJ 07666-6524
Phone
(201) 281-8053
NPI assigned
Dec 28, 2010
Last updated
Dec 28, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 46TR00453600 NJ Primary

Addresses

Primary practice location

206 Lindbergh Blvd
Teaneck, NJ 07666-6524

Mailing address

206 Lindbergh Blvd
Teaneck, NJ 07666-6524
Phone (201) 281-8053

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
46TR00453600NJMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1174827547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 LINDBERGH BLVD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076666524",
            "telephone_number": "201-281-8053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 LINDBERGH BLVD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076666524",
            "telephone_number": "201-281-8053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICK",
        "first_name": "DONNA",
        "middle_name": "NOEL",
        "name_prefix": "Miss",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-28",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00453600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2010; 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.