Individual provider Active NPI

Lisa Ann Peck, M.S.O.T.

  • Occupational Therapist
  • Hopewell Junction, NY
National Provider Identifier
1447403167
Registry record updated Oct 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
012812-1 Issued in NY
Practice address
4 Pellbridge Dr
Hopewell Junction, NY 12533-6229
Phone
(845) 223-6215
NPI assigned
Oct 25, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2008

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 012812-1 NY Primary

Addresses

Primary practice location

4 Pellbridge Dr
Hopewell Junction, NY 12533-6229

Mailing address

4 Pellbridge Dr
Hopewell Junction, NY 12533-6229
Phone (845) 223-6215

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
012812-1NYMDClinical Neuropsychologist

NPI Registry JSON

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

{
    "created_epoch": "1224892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224892800000",
    "number": "1447403167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 PELLBRIDGE DR",
            "city": "HOPEWELL JUNCTION",
            "state": "NY",
            "postal_code": "125336229",
            "telephone_number": "845-223-6215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 PELLBRIDGE DR",
            "city": "HOPEWELL JUNCTION",
            "state": "NY",
            "postal_code": "125336229",
            "telephone_number": "845-223-6215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECK",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.S.O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-25",
        "last_updated": "2008-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "012812-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopewell Junction, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2008; 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.