Cecy-Lizette Bolanos

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

018527-1 Issued in NY

Practice address

307 International Cir Ste 100
Hunt Valley, MD 21030-1387

Phone

(410) 606-7720

NPI assigned

Jan 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Outreach Physical and Occupational Therapy & Speech Rehabilitation, PLLC

  • Physical Therapist
  • Great Neck, NY
  • NPI 1841526399

  Physical Rehabilitation

  Medicare reassignment NPD

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516665600000",
    "number": "1669970711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3213 ASTORIA BLVD APT 2R",
            "city": "ASTORIA",
            "state": "NY",
            "postal_code": "111021117",
            "telephone_number": "269-313-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 INTERNATIONAL CIR STE 100",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "210301387",
            "telephone_number": "410-606-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLANOS",
        "first_name": "CECY-LIZETTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-23",
        "last_updated": "2018-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NY",
            "license": "018527-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monet Blue
• Millicent Boateng
• Jaclyn Boehnke
• Wilfried Boh
• Hadja Boimah
• Desiree Bongiovanni
• Krystiana Bonheur
• Jacqueline Bonilla Rodriguez
• Alisson Bonilla
• Nicole Boulware

• Physical Rehabilitation Occupational Therapist in Hunt Valley, MD
• Providers in Hunt Valley, MD by specialty
• Physical Rehabilitation Occupational Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.