Active NPI
Nicole Desane
- Occupational Therapist
- West Islip, NY
National Provider Identifier
1639321334
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 008554-1
- Practice address
- 1000 Montauk Hwy
Rehabilitation Department
West Islip, NY 11795-4927 - Phone
- (631) 376-3069
- Fax
- (631) 376-3431
- NPI assigned
- Oct 14, 2008
- Last updated
- Oct 14, 2008
- 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 | 008554-1 | NY | Primary |
Addresses
Primary practice location
1000 Montauk Hwy
Rehabilitation Department
West Islip, NY 11795-4927
Mailing address
1000 Montauk Hwy
Rehabilitation Department
West Islip, NY 11795-4927
Phone (631) 376-3069
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 |
|---|---|---|---|
| 008554-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223942400000",
"number": "1639321334",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 MONTAUK HWY",
"address_2": "REHABILITATION DEPARTMENT",
"city": "WEST ISLIP",
"state": "NY",
"postal_code": "117954927",
"telephone_number": "631-376-3069",
"fax_number": "631-376-3431"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 MONTAUK HWY",
"address_2": "REHABILITATION DEPARTMENT",
"city": "WEST ISLIP",
"state": "NY",
"postal_code": "117954927",
"telephone_number": "631-376-3069",
"fax_number": "631-376-3431"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESANE",
"first_name": "NICOLE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-14",
"last_updated": "2008-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "008554-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Islip, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.