Active NPI
Violetta Matayeva
- Occupational Therapist
- Fresh Meadows, NY
National Provider Identifier
1326577875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 021372
- Practice address
- 19502 69TH Ave
Fresh Meadows, NY 11365-4031 - Phone
- (718) 464-4505
- NPI assigned
- Jun 8, 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 Therapist | 225X00000X | 021372 | NY | Primary |
Addresses
Primary practice location
19502 69TH Ave
Fresh Meadows, NY 11365-4031
Mailing address
6539 174TH St
Fresh Meadows, NY 11365-2009
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 |
|---|---|---|---|
| 021372 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1496880000000",
"number": "1326577875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6539 174TH ST",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113652009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19502 69TH AVE",
"city": "FRESH MEADOWS",
"state": "NY",
"postal_code": "113654031",
"telephone_number": "718-464-4505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATAYEVA",
"first_name": "VIOLETTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-08",
"last_updated": "2017-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "021372",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresh Meadows, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.