Individual provider Active NPI

Diana Elizabeth Morocho Fajardo, COTA/L

  • Occupational Therapy Assistant
  • Glendale, NY
National Provider Identifier
1710642186
Registry record updated Nov 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
010900 Issued in NY
Practice address
8288 88TH PL FL 2
Glendale, NY 11385-7818
Phone
(646) 645-5813
NPI assigned
Nov 1, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 010900 NY Primary

Addresses

Primary practice location

8288 88TH PL FL 2
Glendale, NY 11385-7818

Mailing address

8288 88TH PL FL 2
Glendale, NY 11385-7818
Phone (646) 645-5813

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": "1635724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635724800000",
    "number": "1710642186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8288 88TH PL FL 2",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857818",
            "telephone_number": "646-645-5813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8288 88TH PL FL 2",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113857818",
            "telephone_number": "646-645-5813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOROCHO FAJARDO",
        "first_name": "DIANA",
        "middle_name": "ELIZABETH",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-01",
        "last_updated": "2021-11-01",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "010900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.