NPIMap

Organization Active NPI

Diversified Services for Occupational Therapy Physical Ther

  • Early Intervention Provider Agency
  • Kenmore, NY
National Provider Identifier
1518332816
Registry record updated Dec 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
DIVERSIFIED SERVICES FOR OCCUPATIONAL THERAPY PHYSICAL THER
Doing business as
Children's Rehab Services of WNY
Practice address
2900 Delaware Ave
Kenmore, NY 14217-2309
Phone
(716) 871-9883
Fax
(716) 256-1675
NPI assigned
Dec 11, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2015

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

Authorized official

Name
Madonna L Ruggiero
Title
Director of Children'S Services
Phone
(716) 871-9883

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X Primary

Addresses

Primary practice location

2900 Delaware Ave
Kenmore, NY 14217-2309

Mailing address

2900 Delaware Ave
Kenmore, NY 14217-2309

Other identifiers 1

IdentifierTypeStateIssuer
02995691MedicaidNY

Other names 1

  • Children's Rehab Services of WNY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Children'S Rehab Services of Wny4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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": "1449792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449792000000",
    "number": "1518332816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 DELAWARE AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142172309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 DELAWARE AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142172309",
            "telephone_number": "716-871-9883",
            "fax_number": "716-256-1675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVERSIFIED SERVICES FOR OCCUPATIONAL THERAPY PHYSICAL THER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-11",
        "last_updated": "2015-12-11",
        "status": "A",
        "authorized_official_last_name": "RUGGIERO",
        "authorized_official_first_name": "MADONNA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF CHILDREN'S SERVICES",
        "authorized_official_telephone_number": "716-871-9883"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02995691",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Children's Rehab Services of WNY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kenmore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; 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.