Active NPI
Sandra Otero
- Physical Therapy Assistant
- Queensbury, NY
National Provider Identifier
1427368927
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 001756
- Practice address
- 133 Aviation Rd
Queensbury, NY 12804-8206 - Phone
- (518) 798-0170
- Fax
- (518) 761-9538
- NPI assigned
- Oct 18, 2010
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 001756 | NY | Primary |
Addresses
Primary practice location
133 Aviation Rd
Queensbury, NY 12804-8206
Mailing address
133 Aviation Rd
Queensbury, NY 12804-8206
Phone (518) 798-0170
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00752456 | Medicaid | NY |
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 |
|---|---|---|---|
| 001756 | NY | MD | Art Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287360000000",
"number": "1427368927",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "133 AVIATION RD",
"city": "QUEENSBURY",
"state": "NY",
"postal_code": "128048206",
"telephone_number": "518-798-0170",
"fax_number": "518-761-9538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 AVIATION RD",
"city": "QUEENSBURY",
"state": "NY",
"postal_code": "128048206",
"telephone_number": "518-798-0170",
"fax_number": "518-761-9538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTERO",
"first_name": "SANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-18",
"last_updated": "2010-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "NY",
"license": "001756",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00752456",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Queensbury, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.