Active NPI
Victoria Russo, COTA/L
- Occupational Therapy Assistant
- Hamburg, NJ
National Provider Identifier
1235664384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 008868-1
- Practice address
- 17 Tannery Hill Dr
Hamburg, NJ 07419-1236 - Phone
- (973) 600-1407
- NPI assigned
- Apr 26, 2017
- 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 | 008868-1 | NY | Primary |
Addresses
Primary practice location
17 Tannery Hill Dr
Hamburg, NJ 07419-1236
Mailing address
17 Tannery Hill Dr
Hamburg, NJ 07419-1236
Phone (973) 600-1407
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 |
|---|---|---|---|
| 008868-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493164800000",
"number": "1235664384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 TANNERY HILL DR",
"city": "HAMBURG",
"state": "NJ",
"postal_code": "074191236",
"telephone_number": "973-600-1407"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17 TANNERY HILL DR",
"city": "HAMBURG",
"state": "NJ",
"postal_code": "074191236",
"telephone_number": "973-600-1407"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "VICTORIA",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-26",
"last_updated": "2017-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "008868-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hamburg, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.