Elder Berry Petilla

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

014851 Issued in NY

Practice address

4951 Chambers Street
6TH Floor
New York, NY 10007

Phone

(917) 286-5305

NPI assigned

Jun 30, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• Tender Touch Physical Therapy PLLC

  • Physical Therapist
  • Brooklyn, NY
  • NPI 1790797033
  NPD (past)

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1336450865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 33RD AVE",
            "address_2": "APT 3",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111064236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4951 CHAMBERS STREET",
            "address_2": "6TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10007",
            "telephone_number": "917-286-5305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETILLA",
        "first_name": "ELDER BERRY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "014851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Jane Peterson
• Tammy Peterson
• Michael Petetit, MD
• Caroline Petgrave, LCSW-R
• Katherine Alexandra Petherbridge, RN
• Anthony Louis Petillo, RPH
• Dyjenie Petit del, P.A
• Gaelle Petit Homme, RN
• Pascale Petit-de
• Dominique Karenn Petit-Frere, PMHNP

• Occupational Therapist in New York, NY
• Providers in New York, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; 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.