Active NPI
Andrea Rettig, MS OTRL
- Occupational Therapist
- Glen Head, NY
National Provider Identifier
1700922804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 011269-01
- Practice address
- 189 Wheatley Rd
Glen Head, NY 11545-2641 - Phone
- (516) 626-1075
- NPI assigned
- Jan 29, 2007
- 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 | 011269-01 | NY | Primary |
Addresses
Primary practice location
189 Wheatley Rd
Glen Head, NY 11545-2641
Mailing address
41 Neptune Ave
East Patchogue, NY 11772-4829
Phone (631) 730-7914
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011269-01 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170028800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700922804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 NEPTUNE AVE",
"city": "EAST PATCHOGUE",
"state": "NY",
"postal_code": "117724829",
"telephone_number": "631-730-7914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "189 WHEATLEY RD",
"city": "GLEN HEAD",
"state": "NY",
"postal_code": "115452641",
"telephone_number": "516-626-1075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RETTIG",
"first_name": "ANDREA",
"credential": "MS OTRL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "011269-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glen Head, NY
Sources for this page
- 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.