Renee Elizabeth Gamberoni

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

4192 Issued in MA

Practice address

12 Moors End Lane
Nantucket, MA 02554

Phone

(508) 325-4288

NPI assigned

Apr 17, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Renee Elizabeth Wideman Former name

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": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669698767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 MOORS END LANE",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "02554",
            "telephone_number": "508-325-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 MOORS END LANE",
            "city": "NANTUCKET",
            "state": "MA",
            "postal_code": "02554",
            "telephone_number": "508-325-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMBERONI",
        "first_name": "RENEE",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "4192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "WIDEMAN",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Heather Lynne Freeman, M.S. CCC/SLP
• Suzanne Marguerite Fronzuto
• Mayo R Funderburg II, LADCA
• Nancy Palchanis Funderburg, LCSW
• Jessica Pierce Gage, O.D.
• Michael Roger Garrett, MSC HONS P.T.
• Allison Gayo
• Suzanne Gerardi, PT
• Michael Getter
• Mary Graves

• Occupational Therapist in Nantucket, MA
• Providers in Nantucket, MA by specialty
• Occupational Therapist in Massachusetts

• 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.

Verify at the official NPI Registry.