Active NPI
Stephanie Leigh Tyrer, COTA/L
- Occupational Therapy Assistant
- Queensbury, NY
National Provider Identifier
1265275291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 011396-01
- Practice address
- 413 Bay Rd
Queensbury, NY 12804-1408 - Phone
- (518) 761-2025
- NPI assigned
- Jun 17, 2024
- 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 | 011396-01 | NY | Primary |
Addresses
Primary practice location
413 Bay Rd
Queensbury, NY 12804-1408
Mailing address
21 Woodridge Way
Argyle, NY 12809-2844
Phone (518) 932-2500
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 |
|---|---|---|---|
| 011396-01 | NY | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718582400000",
"number": "1265275291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21 WOODRIDGE WAY",
"city": "ARGYLE",
"state": "NY",
"postal_code": "128092844",
"telephone_number": "518-932-2500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "413 BAY RD",
"city": "QUEENSBURY",
"state": "NY",
"postal_code": "128041408",
"telephone_number": "518-761-2025"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYRER",
"first_name": "STEPHANIE",
"middle_name": "LEIGH",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-17",
"last_updated": "2024-06-17",
"certification_date": "2024-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "011396-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queensbury, NY
- Retta Trybendis, LCSW
- Carolyn M Trzaskos, OT
- Machelle Anne Trzaskos, LPN
- Lisa J Tubbs, RN
- Mary H Tyree, MS ED
- Susan Marie Tyrrell, CRPA
- United Cerebral Palsy Association of the Tri-Counties, Inc.
- United Cerebral Palsy Association of the Tri-Counties, Inc.
- Upstate Applied Behavior Analysis Services PLLC
- Peter Joseph Valastro Jr., NP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.