Active NPI
Heather L Dolan, OTR/L
- Occupational Therapist
- Newark, NY
National Provider Identifier
1669535126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 010354-1
- Practice address
- Roosevelt Childrens Center
848 Pierson Avenue
Newark, NY 14513 - Phone
- (315) 331-2086
- Fax
- (315) 331-3215
- NPI assigned
- Dec 18, 2006
- 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 | 010354-1 | NY | Primary |
Addresses
Primary practice location
Roosevelt Childrens Center
848 Pierson Avenue
Newark, NY 14513
Mailing address
Arc Wayne/Roosevelt Childrens Center
848 Peirson Avenue
Newark, NY 14513
Phone (315) 331-2086
Other names 1
- Heather L Sullivan
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010354-1 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seneca Cayuga Counties Chapter Nysarc, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Seneca Cayuga ARC
- Voluntary or Charitable Agency
- Waterloo, NY
- NPI 1497804215
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701820800000",
"number": "1669535126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ARC WAYNE/ROOSEVELT CHILDRENS CENTER",
"address_2": "848 PEIRSON AVENUE",
"city": "NEWARK",
"state": "NY",
"postal_code": "14513",
"telephone_number": "315-331-2086",
"fax_number": "315-331-3215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ROOSEVELT CHILDRENS CENTER",
"address_2": "848 PIERSON AVENUE",
"city": "NEWARK",
"state": "NY",
"postal_code": "14513",
"telephone_number": "315-331-2086",
"fax_number": "315-331-3215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOLAN",
"first_name": "HEATHER",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-18",
"last_updated": "2023-12-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "010354-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "HEATHER",
"last_name": "SULLIVAN",
"middle_name": "L",
"credential": "OTR/L",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Newark, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.