Brenna Natalia Destefano, MSOT, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5274 Issued in CT

Practice address

396 Danbury Rd Ste 2a
Wilton, CT 06897-2024

Phone

(203) 422-2193

NPI assigned

Nov 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Sensory Kids, LLC

  • Occupational Therapist
  • Stamford, CT
  • NPI 1003102880
  NPD (past)

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574640000000",
    "number": "1316583347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 VINCELLETTE ST UNIT 103",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066062267",
            "telephone_number": "570-640-4194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 DANBURY RD STE 2A",
            "city": "WILTON",
            "state": "CT",
            "postal_code": "068972024",
            "telephone_number": "203-422-2193"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "78 Harvard Ave Ste 220",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "069025548",
            "country_code": "US",
            "telephone_number": "203-422-2193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESTEFANO",
        "first_name": "BRENNA",
        "middle_name": "NATALIA",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-25",
        "last_updated": "2019-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "024161",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "5274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICUT DEPARTMENT OF PUBLIC HEALTH",
            "identifier": "5274",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE EDUCATION DEPARTMENT OFFICE OF PROFESSION",
            "identifier": "024161",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Deloma, M.TH., MSPC, PC
• Jeffrey V Deluca, M.D.
• Allison Rose Denicola, APRN, BC
• Dermatology Institute & Wellness Center, LLC
• Barbara Despres, LCSW ACSW
• Laura Jeanne Dias, M.S., CCC-SLP
• Harold Dibner, PH.D.
• Susan Faye Didino
• Annie M Dino, PT
• Direct Behavioral Health Services LLC

• Occupational Therapist in Wilton, CT
• Providers in Wilton, CT by specialty
• Occupational Therapist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2019; 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.