Pathways OT Therapeutic Wellness PLLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

006813 Issued in NY

Legal business name

PATHWAYS OT THERAPEUTIC WELLNESS PLLC

Practice address

1642 63Rd St
Brooklyn, NY 11204-2744

Phone

(718) 234-5700

Fax

(718) 234-5755

NPI assigned

Aug 14, 2014

Last updated

Aug 14, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jim A Ebert, MS OTR

Title

Owner/Director

Phone

(732) 761-0708

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407974400000",
    "number": "1467851477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1642 63RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112042744",
            "telephone_number": "718-234-5700",
            "fax_number": "718-234-5755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1642 63RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112042744",
            "telephone_number": "718-234-5700",
            "fax_number": "718-234-5755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATHWAYS OT THERAPEUTIC WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-08-14",
        "status": "A",
        "authorized_official_last_name": "EBERT",
        "authorized_official_first_name": "JIM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "732-761-0708",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS OTR"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "006813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2014; 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.