Individual provider Active NPI

Renay Sue Pohleven, OTRL

  • Occupational Therapist
  • Utica, NY
National Provider Identifier
1437352218
Registry record updated Apr 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
010445-1 Issued in NY
Practice address
1657 Sunset Ave
Utica, NY 13502-5415
Phone
(315) 797-7392
Fax
(315) 734-9041
NPI assigned
Jun 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 010445-1 NY Primary

Addresses

Primary practice location

1657 Sunset Ave
Utica, NY 13502-5415

Mailing address

1999 Newport Rd
Poland, NY 13431-1714
Phone (315) 845-8914

Other names 1

  • Renay Sue Amendola Former name

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

LicenseStateTypeSpecialty
010445-1NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270425600000",
    "number": "1437352218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1999 NEWPORT RD",
            "city": "POLAND",
            "state": "NY",
            "postal_code": "134311714",
            "telephone_number": "315-845-8914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1657 SUNSET AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025415",
            "telephone_number": "315-797-7392",
            "fax_number": "315-734-9041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POHLEVEN",
        "first_name": "RENAY",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2010-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "010445-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENAY",
            "last_name": "AMENDOLA",
            "middle_name": "SUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Utica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.

Verify at the official NPI Registry.