Active NPI
Dina Wieder, OTR/L
- Occupational Therapist
- Lakewood, NJ
National Provider Identifier
1194178624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 46TR00733600
- Practice address
- 35 Empire LN BSMT
Lakewood, NJ 08701-5163 - Phone
- (732) 998-3145
- NPI assigned
- Jul 20, 2016
- 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 | 020468-1 | NY | |
| Occupational Therapist | 225X00000X | 46TR00733600 | NJ | Primary |
Addresses
Primary practice location
35 Empire LN BSMT
Lakewood, NJ 08701-5163
Mailing address
35 Empire LN BSMT
Lakewood, NJ 08701-5163
Phone (732) 998-3145
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 |
|---|---|---|---|
| 020468-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468972800000",
"number": "1194178624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 EMPIRE LN BSMT",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087015163",
"telephone_number": "732-998-3145"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 EMPIRE LN BSMT",
"city": "LAKEWOOD",
"state": "NJ",
"postal_code": "087015163",
"telephone_number": "732-998-3145"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIEDER",
"first_name": "DINA",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-07-20",
"last_updated": "2016-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "020468-1",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NJ",
"license": "46TR00733600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.