Individual provider Active NPI

Candice Therese Geronimo Rosales, OTR

  • Occupational Therapist
  • Woodhaven, NY
National Provider Identifier
1346948106
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
024150 Issued in NY
Practice address
8802 91St Ave Apt 1L
Woodhaven, NY 11421-2500
Phone
(917) 399-5850
NPI assigned
Feb 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 024150 NY Primary

Addresses

Primary practice location

8802 91St Ave Apt 1L
Woodhaven, NY 11421-2500

Mailing address

8802 91St Ave Apt 1L
Woodhaven, NY 11421-2500
Phone (917) 399-5850

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

NPI Registry JSON

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

{
    "created_epoch": "1676937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703808000000",
    "number": "1346948106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8802 91ST AVE APT 1L",
            "city": "WOODHAVEN",
            "state": "NY",
            "postal_code": "114212500",
            "telephone_number": "917-399-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8802 91ST AVE APT 1L",
            "city": "WOODHAVEN",
            "state": "NY",
            "postal_code": "114212500",
            "telephone_number": "917-399-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSALES",
        "first_name": "CANDICE THERESE",
        "middle_name": "GERONIMO",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "024150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodhaven, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; 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.