Organization Active NPI

Rehabilitation

  • Physical Disabilities Residential Treatment Facility
  • New York, NY
National Provider Identifier
1508929274
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X
License
003295-1 Issued in NY
Legal business name
REHABILITATION
Practice address
210 E 102ND St
#13H
New York, NY 10029-5937
Phone
(212) 876-0659
Fax
(212) 876-0659
NPI assigned
Dec 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Marina Mattei I, O.T.A.
Title
Occupational Therapist Assistant
Phone
(917) 470-7040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Disabilities Residential Treatment Facility 320700000X 003295-1 NY Primary

Addresses

Primary practice location

210 E 102ND St
#13H
New York, NY 10029-5937

Mailing address

210 E 102ND St
#13H
New York, NY 10029-5937
Phone (212) 876-0659

Other identifiers 1

IdentifierTypeStateIssuer
003295-1OtherNYLICENSURE

Other names 1

  • mitchell martin Other name

National Provider Directory

National Provider Directory
Tax ID family
Harlem Hospital Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1166313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508929274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E 102ND ST",
            "address_2": "#13H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100295937",
            "telephone_number": "212-876-0659",
            "fax_number": "212-876-0659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E 102ND ST",
            "address_2": "#13H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100295937",
            "telephone_number": "212-876-0659",
            "fax_number": "212-876-0659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MATTEI",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST ASSISTANT",
        "authorized_official_telephone_number": "917-470-7040",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "O.T.A."
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "NY",
            "license": "003295-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSURE",
            "identifier": "003295-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "mitchell martin",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.