Nico Italiani

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OTH-008254 Issued in AZ

Practice address

701 Slate Belt Blvd
Bangor, PA 18013-9341

Phone

(610) 588-9933

Fax

(610) 599-1418

NPI assigned

Nov 14, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1384387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604188800000",
    "number": "1427488337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5321 GREEN POND RD",
            "city": "EASTON",
            "state": "PA",
            "postal_code": "180452923",
            "telephone_number": "610-216-6199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SLATE BELT BLVD",
            "city": "BANGOR",
            "state": "PA",
            "postal_code": "180139341",
            "telephone_number": "610-588-9933",
            "fax_number": "610-599-1418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITALIANI",
        "first_name": "NICO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-14",
        "last_updated": "2020-11-01",
        "certification_date": "2020-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "PA",
            "license": "OP007243",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "PA",
            "license": "OC017012",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH-008254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heavenly Vision
• Kaley Hippensteal
• Brigitte Renee Hoffman, M.A.
• Kathleen Anne Hope, DPM
• Jessica Eden Hudnall, OTR/L
• Kelly Jaczynski
• Stephanie Kettle, OTR/L
• Anna Joy King, COTA
• Debra Knicos, MA ATR-BC LCAT
• Elizabeth Kostura, M.S.

• Occupational Therapist in Bangor, PA
• Providers in Bangor, PA by specialty
• Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.