Active NPI
Bonnie Lynn Rubell
- Occupational Therapist
- Oakdale, NY
National Provider Identifier
1609919984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0021831
- Practice address
- 1227 2 Montauk Highway
Tender Age PT Inc
Oakdale, NY 11769 - Phone
- (631) 218-1545
- Fax
- (631) 218-2650
- NPI assigned
- Feb 15, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 0021831 | NY | Primary |
Addresses
Primary practice location
1227 2 Montauk Highway
Tender Age PT Inc
Oakdale, NY 11769
Mailing address
562 Chester Road
Sayville, NY 11782
Phone (631) 750-3382
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 |
|---|---|---|---|
| 0021831 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609919984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "562 CHESTER ROAD",
"city": "SAYVILLE",
"state": "NY",
"postal_code": "11782",
"telephone_number": "631-750-3382"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1227 2 MONTAUK HIGHWAY",
"address_2": "TENDER AGE PT INC",
"city": "OAKDALE",
"state": "NY",
"postal_code": "11769",
"telephone_number": "631-218-1545",
"fax_number": "631-218-2650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUBELL",
"first_name": "BONNIE",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "0021831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakdale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.