Individual provider Active NPI

Geraldine Legeorgia Mowatt, OTR/L

  • Pediatric Occupational Therapist
  • Valley Stream, NY
National Provider Identifier
1720391444
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
002446-1 Issued in NY
Practice address
63 Birchwood Dr S
Valley Stream, NY 11580-1941
Phone
(516) 812-8549
NPI assigned
Jul 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Occupational Therapist 225XG0600X 002446-1 NY
Pediatric Occupational Therapist 225XP0200X 002446-1 NY Primary

Addresses

Primary practice location

63 Birchwood Dr S
Valley Stream, NY 11580-1941

Mailing address

63 Birchwood Dr S
Valley Stream, NY 11580-1941
Phone (516) 812-8549

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
002446-1NYMDPhysical Therapist
002446NYMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1279756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1720391444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 BIRCHWOOD DR S",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801941",
            "telephone_number": "516-812-8549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 BIRCHWOOD DR S",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115801941",
            "telephone_number": "516-812-8549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOWATT",
        "first_name": "GERALDINE",
        "middle_name": "LEGEORGIA",
        "name_prefix": "Ms.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-22",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": "NY",
            "license": "002446-1",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "002446-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; 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.