Individual provider Active NPI

Renee Deluke, OT

  • Specialist
  • Latham, NY
National Provider Identifier
1225048077
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
009431-1 Issued in NY
Practice address
711 Troy Schenectady Rd
Suite 216
Latham, NY 12110-2442
Phone
(518) 786-1665
Fax
(518) 786-0056
NPI assigned
Aug 8, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 009431-1 NY Primary

Addresses

Primary practice location

711 Troy Schenectady Rd
Suite 216
Latham, NY 12110-2442

Mailing address

29 Bancker Ave
Scotia, NY 12302-3103

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

LicenseStateTypeSpecialty
009431-1NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas Nicolla Consulting Services, PLLC Specialist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225048077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 BANCKER AVE",
            "city": "SCOTIA",
            "state": "NY",
            "postal_code": "123023103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 216",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "telephone_number": "518-786-1665",
            "fax_number": "518-786-0056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELUKE",
        "first_name": "RENEE",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "009431-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Latham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.