Active NPI
George Jake Canal, OCCUP. THERAPIST
- Occupational Therapist
- Mohegan Lake, NY
National Provider Identifier
1598073892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 006932
- Practice address
- 1401 Christine Rd
Mohegan Lake, NY 10547-1774 - Phone
- (646) 339-4439
- NPI assigned
- Sep 20, 2010
- Last updated
- Sep 20, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 006932 | NY | Primary |
Addresses
Primary practice location
1401 Christine Rd
Mohegan Lake, NY 10547-1774
Mailing address
1401 Christine Rd
Mohegan Lake, NY 10547-1774
Phone (646) 339-4439
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 931767939 | Other | NY | UNITED FEDERATION OF TEACHERS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 006932 | NY | MD | Psychoanalysis Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1284940800000",
"number": "1598073892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 CHRISTINE RD",
"city": "MOHEGAN LAKE",
"state": "NY",
"postal_code": "105471774",
"telephone_number": "646-339-4439"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 CHRISTINE RD",
"city": "MOHEGAN LAKE",
"state": "NY",
"postal_code": "105471774",
"telephone_number": "646-339-4439"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANAL",
"first_name": "GEORGE",
"middle_name": "JAKE",
"name_prefix": "Mr.",
"credential": "OCCUP. THERAPIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-09-20",
"last_updated": "2010-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "006932",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED FEDERATION OF TEACHERS",
"identifier": "931767939",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mohegan Lake, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.