Individual provider Active NPI

Heather Fawn Fiacco, C.O.T.A

  • Occupational Therapy Assistant
  • Lewiston, NY
National Provider Identifier
1568617009
Registry record updated Nov 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
005621F Issued in NY
Practice address
5300 Military Rd
Mt. St. Mary's Hospital Room 526
Lewiston, NY 14092-1903
Phone
(716) 298-2253
Fax
(716) 298-2471
NPI assigned
Nov 25, 2008
Last updated
Nov 25, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2008

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 005621F NY Primary

Addresses

Primary practice location

5300 Military Rd
Mt. St. Mary's Hospital Room 526
Lewiston, NY 14092-1903

Mailing address

5300 Military Rd
Lewiston, NY 14092-1903
Phone (716) 298-2253

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
005621FNYMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227571200000",
    "number": "1568617009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 MILITARY RD",
            "city": "LEWISTON",
            "state": "NY",
            "postal_code": "140921903",
            "telephone_number": "716-298-2253",
            "fax_number": "716-298-2471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5300 MILITARY RD",
            "address_2": "MT. ST. MARY'S HOSPITAL ROOM 526",
            "city": "LEWISTON",
            "state": "NY",
            "postal_code": "140921903",
            "telephone_number": "716-298-2253",
            "fax_number": "716-298-2471"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIACCO",
        "first_name": "HEATHER",
        "middle_name": "FAWN",
        "name_prefix": "Mrs.",
        "credential": "C.O.T.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-25",
        "last_updated": "2008-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "005621F",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2008; 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.