Active NPI
Gabrielle Broadley
- Occupational Therapy Assistant
- West Nyack, NY
National Provider Identifier
1336489194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 007880-1
- Practice address
- 3 Davenport Ter
West Nyack, NY 10994-1334 - Phone
- (845) 558-0236
- NPI assigned
- Feb 15, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 | 007880-1 | NY | Primary |
Addresses
Primary practice location
3 Davenport Ter
West Nyack, NY 10994-1334
Mailing address
3 Davenport Ter
West Nyack, NY 10994-1334
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 |
|---|---|---|---|
| 007880-1 | NY | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360886400000",
"number": "1336489194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3 DAVENPORT TER",
"city": "WEST NYACK",
"state": "NY",
"postal_code": "109941334"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3 DAVENPORT TER",
"city": "WEST NYACK",
"state": "NY",
"postal_code": "109941334",
"telephone_number": "845-558-0236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROADLEY",
"first_name": "GABRIELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-02-15",
"last_updated": "2013-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "007880-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Nyack, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.