NPIMap

Organization Active NPI

Functional Body Occupational Therapy P.C.

  • Early Intervention Provider Agency
  • Rosedale, NY
National Provider Identifier
1417587510
Registry record updated Jan 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
FUNCTIONAL BODY OCCUPATIONAL THERAPY P.C.
Practice address
24024 Memphis Ave
Rosedale, NY 11422-2017
Phone
(917) 340-1645
NPI assigned
Jan 17, 2020
Last updated
Jan 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2020

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

Authorized official

Name
Mrs. Farah Quettant-Vergin, MS, OTR/LNPI 1861792087
Title
Occupational Therapist
Phone
(917) 340-1645

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

24024 Memphis Ave
Rosedale, NY 11422-2017

Mailing address

24024 Memphis Ave
Rosedale, NY 11422-2017
Phone (917) 340-1645

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579219200000",
    "number": "1417587510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24024 MEMPHIS AVE",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222017",
            "telephone_number": "917-340-1645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24024 MEMPHIS AVE",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222017",
            "telephone_number": "917-340-1645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL BODY OCCUPATIONAL THERAPY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A",
        "authorized_official_last_name": "QUETTANT-VERGIN",
        "authorized_official_first_name": "FARAH",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "917-340-1645",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, OTR/L"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; 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.