Active NPI
Elizabeth Degennaro, OTR/L
- Occupational Therapist
- Pearl River, NY
National Provider Identifier
1699209502
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 021268-1
- Practice address
- 81 Roosevelt St
Pearl River, NY 10965-1818 - Phone
- (845) 269-0086
- NPI assigned
- Apr 18, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 | 021268-1 | NY | Primary |
Addresses
Primary practice location
81 Roosevelt St
Pearl River, NY 10965-1818
Mailing address
81 Roosevelt St
Pearl River, NY 10965-1818
Phone (845) 269-0086
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
| License | State | Type | Specialty |
|---|---|---|---|
| 021268-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492473600000",
"number": "1699209502",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "81 ROOSEVELT ST",
"city": "PEARL RIVER",
"state": "NY",
"postal_code": "109651818",
"telephone_number": "845-269-0086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "81 ROOSEVELT ST",
"city": "PEARL RIVER",
"state": "NY",
"postal_code": "109651818",
"telephone_number": "845-269-0086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEGENNARO",
"first_name": "ELIZABETH",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-18",
"last_updated": "2017-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "021268-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pearl River, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.