Individual provider Active NPI

Diane Marie Zagacki, COTA

  • Occupational Therapy Assistant
  • North Bergen, NJ
National Provider Identifier
1497948673
Registry record updated Sep 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
46TA09048400 Issued in NJ
Practice address
9020 Wall St
North Bergen, NJ 07047
Phone
(201) 809-2900
NPI assigned
Aug 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2007

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 46TA09048400 NJ Primary

Addresses

Primary practice location

9020 Wall St
North Bergen, NJ 07047

Mailing address

9020 Wall St
North Bergen, NJ 07047
Phone (201) 809-2900

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
46TA09048400NJMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189296000000",
    "number": "1497948673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9020 WALL ST",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "07047",
            "telephone_number": "201-809-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9020 WALL ST",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "07047",
            "telephone_number": "201-809-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAGACKI",
        "first_name": "DIANE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-22",
        "last_updated": "2007-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NJ",
            "license": "46TA09048400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Bergen, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2007; 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.