NPIMap

Organization Active NPI

Pediatric Therapeutics-PT,OT,SLP&CSW,PLLC

  • Early Intervention Provider Agency
  • Buffalo, NY
National Provider Identifier
1265697882
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
License
4752568 Issued in NY
Legal business name
PEDIATRIC THERAPEUTICS-PT,OT,SLP&CSW,PLLC
Practice address
90 Pearl St
Buffalo, NY 14202-4106
Phone
(716) 362-0020
Fax
(716) 362-0022
NPI assigned
Jul 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Authorized official

Name
Ms. Marybeth Dejohn, PT
Title
Executive Director
Phone
(716) 362-0020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X 4752568 NY Primary

Addresses

Primary practice location

90 Pearl St
Buffalo, NY 14202-4106

Mailing address

90 Pearl St
Buffalo, NY 14202-4106
Phone (716) 362-0020

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1265697882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 PEARL ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142024106",
            "telephone_number": "716-362-0020",
            "fax_number": "716-362-0022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 PEARL ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142024106",
            "telephone_number": "716-362-0020",
            "fax_number": "716-362-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC THERAPEUTICS-PT,OT,SLP&CSW,PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-23",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "DEJOHN",
        "authorized_official_first_name": "MARYBETH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "716-362-0020",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "4752568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buffalo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.