Active NPI
Stephanie Fava, OTR/L
- Occupational Therapist
- Hawthorne, NY
National Provider Identifier
1396390324
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 023541
- Practice address
- 5 Bradhurst Ave
Hawthorne, NY 10532-2135 - Phone
- (917) 826-0765
- NPI assigned
- Aug 6, 2019
- 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 Therapist | 225X00000X | 023541 | NY | Primary |
Addresses
Primary practice location
5 Bradhurst Ave
Hawthorne, NY 10532-2135
Mailing address
5 Bradhurst Ave
Hawthorne, NY 10532-2135
Phone (917) 826-0765
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 |
|---|---|---|---|
| 023541 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565049600000",
"number": "1396390324",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 BRADHURST AVE",
"city": "HAWTHORNE",
"state": "NY",
"postal_code": "105322135",
"telephone_number": "917-826-0765"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 BRADHURST AVE",
"city": "HAWTHORNE",
"state": "NY",
"postal_code": "105322135",
"telephone_number": "917-826-0765"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAVA",
"first_name": "STEPHANIE",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-06",
"last_updated": "2019-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "NY",
"license": "023541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hawthorne, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.