Active NPI
Ilana Bravo, OTR-L
- Occupational Therapist
- Islip Terrace, NY
National Provider Identifier
1366161259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 027039
- Practice address
- 67 Lincoln Ave
Islip Terrace, NY 11752-2818 - Phone
- (516) 650-1719
- NPI assigned
- Aug 24, 2022
- 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 | 027039 | NY | Primary |
Addresses
Primary practice location
67 Lincoln Ave
Islip Terrace, NY 11752-2818
Mailing address
67 Lincoln Ave
Islip Terrace, NY 11752-2818
Phone (516) 650-1719
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": "1661299200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661299200000",
"number": "1366161259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 LINCOLN AVE",
"city": "ISLIP TERRACE",
"state": "NY",
"postal_code": "117522818",
"telephone_number": "516-650-1719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 LINCOLN AVE",
"city": "ISLIP TERRACE",
"state": "NY",
"postal_code": "117522818",
"telephone_number": "516-650-1719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAVO",
"first_name": "ILANA",
"credential": "OTR-L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-24",
"last_updated": "2022-08-24",
"certification_date": "2022-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "027039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Islip Terrace, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.