Debra Anne Colacicco Wilson, MS OTR

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

002012-1 Issued in NY

Practice address

171 Intrepid LN
Syracuse, NY 13205-2548

Phone

(315) 437-4689

NPI assigned

Nov 29, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Network for Children'S Speech, Occupational and Physical Therapy

  • Early Intervention Provider Agency
  • Syracuse, NY
  • NPI 1619113255
  NPD (past)

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

{
    "created_epoch": "1227916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227916800000",
    "number": "1720233091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7185 FREMONT RD",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579445",
            "telephone_number": "315-656-3602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 INTREPID LN",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132052548",
            "telephone_number": "315-437-4689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLACICCO WILSON",
        "first_name": "DEBRA",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "MS OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-29",
        "last_updated": "2008-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "002012-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rishana Sklaroff Cohen, M.D.
• Stephen Mark Cohen, M.D.
• Willard - Cohen, M.D.
• Marcel Coker, CRPA, CASAC-T
• Viccarra Rachel Coker, LPN
• Mark J Colaneri, P.A.
• Pamela Colangelo, OTR
• Cesar A Colasante-Garrido, M.D.
• Beth Colbert, OT CHT
• Matthew E Colbert, RN

• Pediatric Occupational Therapist in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Pediatric Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2008; 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.