Marguerite Jean Conners Deforge, OTD, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

029174 Issued in NY

Practice address

196 Low Rd
Malone, NY 12953-4002

Phone

(315) 573-2102

NPI assigned

Aug 15, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1609422591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 LOW RD",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129534002",
            "telephone_number": "315-573-2102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 LOW RD",
            "city": "MALONE",
            "state": "NY",
            "postal_code": "129534002",
            "telephone_number": "315-573-2102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEFORGE",
        "first_name": "MARGUERITE",
        "middle_name": "JEAN CONNERS",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "13267",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "13239",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "029174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah E Dauenhauer
• George Berton Davis II, M.D.
• Heloisa Bueno De Castro
• Ava Deangelis
• Jessica Defayette
• Josephine Delaney, MPH, MS
• Jessica Lynn Delisle
• Nancy Denis
• Denzell Dennis
• Troy J Deno

• Occupational Therapist in Malone, NY
• Providers in Malone, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.