Individual provider Active NPI

Danielle Moya

  • Occupational Therapy Assistant
  • Wallingford, CT
National Provider Identifier
1639965783
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2158 Issued in CT
Practice address
22 Masonic Ave
Wallingford, CT 06492-3048
Phone
(203) 907-5096
NPI assigned
Apr 16, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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 2158 CT Primary

Addresses

Primary practice location

22 Masonic Ave
Wallingford, CT 06492-3048

Mailing address

960 Old Rock Hill Rd
Wallingford, CT 06492-3964
Phone (203) 907-5096

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
2158CTMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1744761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1639965783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 OLD ROCK HILL RD",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064923964",
            "telephone_number": "203-907-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 MASONIC AVE",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064923048",
            "telephone_number": "203-907-5096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYA",
        "first_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-16",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CT",
            "license": "2158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; 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.