Individual provider Active NPI

Claire Davidson Mullany

  • Developmental Therapist
  • Fresh Meadows, NY
National Provider Identifier
1710655964
Registry record updated Sep 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
License
2789616 Issued in NY
Practice address
6143 186TH St
Fresh Meadows, NY 11365-2710
Phone
(929) 200-7105
NPI assigned
Sep 2, 2021
Last updated
Sep 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X 2789616 NY Primary

Addresses

Primary practice location

6143 186TH St
Fresh Meadows, NY 11365-2710

Mailing address

317 E 18TH St Apt 3E
New York, NY 10003-2775
Phone (646) 761-8960

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

LicenseStateTypeSpecialty
2789616NYMDDevelopmental Therapist

NPI Registry JSON

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630886400000",
    "number": "1710655964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 E 18TH ST APT 3E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100032775",
            "telephone_number": "646-761-8960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6143 186TH ST",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652710",
            "telephone_number": "929-200-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLANY",
        "first_name": "CLAIRE",
        "middle_name": "DAVIDSON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-06",
        "certification_date": "2021-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "NY",
            "license": "2789616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.