Active NPI
Stephanie Gerena, OTR/L
- Contractor
- Wayne, NJ
National Provider Identifier
1407158371
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 46TR00218900
- Practice address
- 1039 Black Oak Ridge Rd
Wayne, NJ 07470-6340 - Phone
- (973) 980-3442
- Fax
- (973) 835-4697
- NPI assigned
- Nov 29, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 46TR00218900 | NJ | Primary |
| Contractor | 171W00000X | 008610-1 | NY |
Addresses
Primary practice location
1039 Black Oak Ridge Rd
Wayne, NJ 07470-6340
Mailing address
1039 Black Oak Ridge Rd
Wayne, NJ 07470-6340
Phone (973) 980-3442
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 008610-1 | Other | NY | OCCUPATIONAL THERAPY |
| 46TR00218900 | Other | NJ | OCCUPATIONAL THERAPY |
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 |
|---|---|---|---|
| 008610-1 | NY | MD | Optician |
| 46TR00218900 | NJ | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290988800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290988800000",
"number": "1407158371",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1039 BLACK OAK RIDGE RD",
"city": "WAYNE",
"state": "NJ",
"postal_code": "074706340",
"telephone_number": "973-980-3442",
"fax_number": "973-835-4697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1039 BLACK OAK RIDGE RD",
"city": "WAYNE",
"state": "NJ",
"postal_code": "074706340",
"telephone_number": "973-980-3442",
"fax_number": "973-835-4697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERENA",
"first_name": "STEPHANIE",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-29",
"last_updated": "2010-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "NJ",
"license": "46TR00218900",
"primary": true
},
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "NY",
"license": "008610-1",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPY",
"identifier": "008610-1",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPY",
"identifier": "46TR00218900",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wayne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.