Tricia Bennett

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

TRICIA BENNETT

Practice address

148 Otis Rd
East Patchogue, NY 11772-6258

Phone

(631) 286-2797

NPI assigned

Jul 26, 2012

Organization subpart

No

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

Authorized official

Name

Tricia Lynn Bennett, MS.ED

Title

Special Education Reacher

Phone

(631) 514-5963

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1487900536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 OTIS RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117726258",
            "telephone_number": "631-286-2797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 OTIS RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117726258",
            "telephone_number": "631-286-2797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRICIA BENNETT",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-26",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "TRICIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "SPECIAL EDUCATION REACHER",
        "authorized_official_telephone_number": "631-514-5963",
        "authorized_official_credential": "MS.ED"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": null,
            "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 Jul 21, 2022; 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.