Individual provider Active NPI

Jean Barbara Halisky, COTA/L

  • Occupational Therapy Assistant
  • Staten Island, NY
National Provider Identifier
1184878472
Registry record updated Nov 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
003869-1 Issued in NY
Practice address
45 Ocean Ter
Staten Island, NY 10314-5625
Phone
(646) 529-5306
NPI assigned
Nov 13, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 003869-1 NY Primary

Addresses

Primary practice location

45 Ocean Ter
Staten Island, NY 10314-5625

Mailing address

45 Ocean Ter
Staten Island, NY 10314-5625
Phone (646) 529-5306

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
003869-1NYMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1226534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226534400000",
    "number": "1184878472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 OCEAN TER",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145625",
            "telephone_number": "646-529-5306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 OCEAN TER",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103145625",
            "telephone_number": "646-529-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALISKY",
        "first_name": "JEAN",
        "middle_name": "BARBARA",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-13",
        "last_updated": "2008-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "003869-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2008; 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.