Individual provider Active NPI

Courtney Critelli, COTA

  • Occupational Therapy Assistant
  • Teaneck, NJ
National Provider Identifier
1497422133
Registry record updated Aug 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
46TA09214600 Issued in NJ
Practice address
205 W Englewood Ave
Teaneck, NJ 07666-3526
Phone
(201) 357-0417
NPI assigned
Aug 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 46TA09214600 NJ Primary

Addresses

Primary practice location

205 W Englewood Ave
Teaneck, NJ 07666-3526

Mailing address

5 Superfine Rd
High Bridge, NJ 08829-1101

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
46TA09214600NJMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Therapy Gym PastSince Sep 5, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1630195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630195200000",
    "number": "1497422133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 SUPERFINE RD",
            "city": "HIGH BRIDGE",
            "state": "NJ",
            "postal_code": "088291101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 W ENGLEWOOD AVE",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663526",
            "telephone_number": "201-357-0417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRITELLI",
        "first_name": "COURTNEY",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-29",
        "last_updated": "2021-08-29",
        "certification_date": "2021-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NJ",
            "license": "46TA09214600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2021; 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.