Active NPI
Douglas A Hallam, COTA/L
- Occupational Therapy Assistant
- Purchase, NY
National Provider Identifier
1427692383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 010228
- Practice address
- 2700 Westchester Ave Ste 300
Purchase, NY 10577-2554 - Phone
- (914) 323-2868
- NPI assigned
- Nov 4, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 010228 | NY | Primary |
Addresses
Primary practice location
2700 Westchester Ave Ste 300
Purchase, NY 10577-2554
Mailing address
46 Peterson CT
Pearl River, NY 10965-2865
Phone (845) 558-0185
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 |
|---|---|---|---|
| 010228 | NY | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572825600000",
"number": "1427692383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46 PETERSON CT",
"city": "PEARL RIVER",
"state": "NY",
"postal_code": "109652865",
"telephone_number": "845-558-0185"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 WESTCHESTER AVE STE 300",
"city": "PURCHASE",
"state": "NY",
"postal_code": "105772554",
"telephone_number": "914-323-2868"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLAM",
"first_name": "DOUGLAS",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-11-04",
"last_updated": "2019-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "010228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Purchase, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.