Active NPI
Marnie Capobianco
- Occupational Therapy Assistant
- Waterbury, CT
National Provider Identifier
1205170479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 000862
- Practice address
- 145 Grove St
Waterbury, CT 06710-2202 - Phone
- (203) 753-7205
- NPI assigned
- Nov 12, 2012
- Last updated
- Nov 12, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 000862 | CT | Primary |
Addresses
Primary practice location
145 Grove St
Waterbury, CT 06710-2202
Mailing address
145 Grove St
Waterbury, CT 06710-2202
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
| License | State | Type | Specialty |
|---|---|---|---|
| 000862 | CT | MD | Community/Behavioral Health Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352678400000",
"number": "1205170479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 GROVE ST",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067102202"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 GROVE ST",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067102202",
"telephone_number": "203-753-7205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAPOBIANCO",
"first_name": "MARNIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-12",
"last_updated": "2012-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CT",
"license": "000862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.