Individual provider Active NPI

Sheldon J Taback, MS.OTR

  • Contractor
  • White Plains, NY
National Provider Identifier
1184938409
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
001098-1 Issued in NY
Practice address
90 Bryant Ave Apt 3BB
White Plains, NY 10605-1934
Phone
(914) 772-4007
NPI assigned
Jul 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X 001098-1 NY Primary

Addresses

Primary practice location

90 Bryant Ave Apt 3BB
White Plains, NY 10605-1934

Mailing address

90 Bryant Ave Apt 3BB
White Plains, NY 10605-1934
Phone (914) 772-4007

Other identifiers 1

IdentifierTypeStateIssuer
001098-1OtherNYOCCUPATIONAL THERAPY

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
001098-1NYMDNutritionist

NPI Registry JSON

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1184938409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 BRYANT AVE APT 3BB",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051934",
            "telephone_number": "914-772-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 BRYANT AVE APT 3BB",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106051934",
            "telephone_number": "914-772-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABACK",
        "first_name": "SHELDON",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "MS.OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-28",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "NY",
            "license": "001098-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPY",
            "identifier": "001098-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

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