Kimberly Ann Clyne, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

004341 Issued in NY

Practice address

100 Saratoga Village Blvd
Suite35
Malta, NY 12020-3737

Phone

(518) 899-9235

NPI assigned

Mar 15, 2015

Sex

Female

Sole proprietor

Yes

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Newmeadow, Inc.

  • Early Intervention Provider Agency
  • Clifton Park, NY
  • NPI 1831342963
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 15, 2015.

{
    "created_epoch": "1426377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426377600000",
    "number": "1467845461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SARATOGA VILLAGE BLVD",
            "address_2": "SUITE35",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120203737",
            "telephone_number": "518-899-9235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SARATOGA VILLAGE BLVD",
            "address_2": "SUITE35",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120203737",
            "telephone_number": "518-899-9235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLYNE",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-15",
        "last_updated": "2015-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "004341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julianne Ceci-Lansing, COTA/L
• Lena Cho
• Jenness Clairmont, LCSW
• Harry M Clark III
• Tracy L Clark, LCSW-R
• Christina Cocozzo, DDS
• Dawn Constantine, LCSW-R
• Cassandra Coppola
• Stacey Cornell
• Cindi Cox

• All providers in Malta, NY
• Occupational Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2015; 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.