Nichole Dicristo, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

022946 Issued in NY

Practice address

130 Montauk Hwy
East Moriches, NY 11940-1153

Phone

(631) 874-0571

NPI assigned

Sep 21, 2018

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

Other names 1

• Nichole Shore Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1366926727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 HOLIDAY BLVD",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "119343011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 MONTAUK HWY",
            "city": "EAST MORICHES",
            "state": "NY",
            "postal_code": "119401153",
            "telephone_number": "631-874-0571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICRISTO",
        "first_name": "NICHOLE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-21",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "022946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "SHORE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Veronica M Damm
• Victoria D Damm
• Dorothy De Marco, ABSS
• Krista Debler Seidel, OTRL
• Devendra K Singh MDPC
• Christine Ruth Dodd, OTR/L
• Timothy William Dodd Sr.
• Julie L Dyer, LPN
• East End Internal Medicine PC
• East Moriches Union Free School District

• All providers in East Moriches, NY
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.