Active NPI
Petrona Elizabeth Royal, COTA
- Occupational Therapy Assistant
- Amityville, NY
National Provider Identifier
1497047260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1073084
- Practice address
- 19 Bentley Rd
Amityville, NY 11701-1703 - Phone
- (631) 278-3932
- NPI assigned
- May 11, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 1073084 | MD | Primary |
Addresses
Primary practice location
19 Bentley Rd
Amityville, NY 11701-1703
Mailing address
19 Bentley Rd
Amityville, NY 11701-1703
Phone (631) 278-3932
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1073084 | MD | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1305072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305072000000",
"number": "1497047260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19 BENTLEY RD",
"city": "AMITYVILLE",
"state": "NY",
"postal_code": "117011703",
"telephone_number": "631-278-3932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19 BENTLEY RD",
"city": "AMITYVILLE",
"state": "NY",
"postal_code": "117011703",
"telephone_number": "631-278-3932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROYAL",
"first_name": "PETRONA",
"middle_name": "ELIZABETH",
"name_prefix": "Miss",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-11",
"last_updated": "2011-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapy Assistant",
"state": "MD",
"license": "1073084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Amityville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.