Individual provider Active NPI

Malgorzata Maria Petukh

  • Occupational Therapist
  • Yorktown Heights, NY
National Provider Identifier
1679910830
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
1940 Commerce St Ste 210
Yorktown Heights, NY 10598-4448
Phone
(191) 442-0313
NPI assigned
May 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

1940 Commerce St Ste 210
Yorktown Heights, NY 10598-4448

Mailing address

1940 Commerce St Ste 210
Yorktown Heights, NY 10598-4448
Phone (191) 442-0313

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

NPI Registry JSON

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369785600000",
    "number": "1679910830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 COMMERCE ST STE 210",
            "city": "YORKTOWN HEIGHTS",
            "state": "NY",
            "postal_code": "105984448",
            "telephone_number": "191-442-0313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 COMMERCE ST STE 210",
            "city": "YORKTOWN HEIGHTS",
            "state": "NY",
            "postal_code": "105984448",
            "telephone_number": "191-442-0313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETUKH",
        "first_name": "MALGORZATA",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-29",
        "last_updated": "2013-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorktown Heights, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.