Desiree Kopil Gannon, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

008498-1 Issued in NY

Practice address

131 Safran Ave
Edison, NJ 08837-3205

Phone

(732) 742-3749

Fax

(732) 709-3388

NPI assigned

Feb 26, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Desiree Marie Kopil Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1235606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1508006883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 SAFRAN AVE",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088373205",
            "telephone_number": "732-742-3749",
            "fax_number": "732-709-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 SAFRAN AVE",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088373205",
            "telephone_number": "732-742-3749",
            "fax_number": "732-709-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNON",
        "first_name": "DESIREE",
        "middle_name": "KOPIL",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-26",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "008498-1",
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NJ",
            "license": "46TR00098800",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DESIREE",
            "last_name": "KOPIL",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gaming Approaches Toward Education
• Richard A Gan, MD
• Anuja H Gandhi, PT, DPT
• Nabila A Gandhi, MD
• Agrahara Ganeshamurthy, MD
• Lynn A Gannon, RPH
• Laura V Ganny
• Patricia Gao, M.D.
• Ana Laura Garaicoa
• Ayman Garas

• Pediatric Occupational Therapist in Edison, NJ
• Providers in Edison, NJ by specialty
• Pediatric Occupational Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.