Individual provider Active NPI

Maureen Studdert Dibello, OT

  • Pediatric Occupational Therapist
  • Mahopac, NY
National Provider Identifier
1235381195
Registry record updated Oct 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
003532-1 Issued in NY
Practice address
34 Logan Rd
Mahopac, NY 10541-1926
Phone
(845) 621-4338
Fax
(845) 621-4338
NPI assigned
Oct 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 003532-1 NY Primary

Addresses

Primary practice location

34 Logan Rd
Mahopac, NY 10541-1926

Mailing address

34 Logan Rd
Mahopac, NY 10541-1926
Phone (845) 621-4338

Other names 1

  • Ms. Maureen Ann Studdert Former name

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
003532-1NYMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224633600000",
    "number": "1235381195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 LOGAN RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105411926",
            "telephone_number": "845-621-4338",
            "fax_number": "845-621-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 LOGAN RD",
            "city": "MAHOPAC",
            "state": "NY",
            "postal_code": "105411926",
            "telephone_number": "845-621-4338",
            "fax_number": "845-621-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBELLO",
        "first_name": "MAUREEN",
        "middle_name": "STUDDERT",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-22",
        "last_updated": "2008-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "003532-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAUREEN",
            "last_name": "STUDDERT",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "OT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mahopac, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.