Nicole Brennan, MSOT R/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0119008759 Issued in VA

Practice address

3509 Granby St Ste B
Norfolk, VA 23504-1312

Phone

(757) 423-8885

Fax

(757) 423-8886

NPI assigned

Oct 7, 2020

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

Other names 1

• Nicole Del Busto Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1720685381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 MAMARONECK AVE STE 140",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106055224",
            "telephone_number": "914-294-4050",
            "fax_number": "631-760-8306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3509 GRANBY ST STE B",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235041312",
            "telephone_number": "757-423-8885",
            "fax_number": "757-423-8886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "NICOLE",
        "credential": "MSOT R/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119008759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "DEL BUSTO",
            "credential": "MSOT R/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Breast Care Specialists PC
• Steven Robert Breault, M.D.
• Nicole Brecher, CRNA
• Elma Brein, CRNA
• James Joseph Brennan, MD
• Joel S Brenner, M.D.
• Michelle G. Brenner, MD
• Mila Brooks Brenner, NP
• Herbert Martin Brewer, MD
• Jaquris Dashun Brewer

• Occupational Therapist in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.