Active NPI
Jennifer Guaetta, COTA
- Occupational Therapy Assistant
- Woburn, MA
National Provider Identifier
1730365537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 2831
- Practice address
- 400 W Cummings Park
Suite 3950
Woburn, MA 01801-6519 - Phone
- (781) 933-8800
- NPI assigned
- Jan 11, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 2831 | MA | Primary |
Addresses
Primary practice location
400 W Cummings Park
Suite 3950
Woburn, MA 01801-6519
Mailing address
100 Everett St
East Boston, MA 02128-2232
Phone (617) 561-3858
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2831 | MA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200009600000",
"number": "1730365537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 EVERETT ST",
"city": "EAST BOSTON",
"state": "MA",
"postal_code": "021282232",
"telephone_number": "617-561-3858"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 W CUMMINGS PARK",
"address_2": "SUITE 3950",
"city": "WOBURN",
"state": "MA",
"postal_code": "018016519",
"telephone_number": "781-933-8800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUAETTA",
"first_name": "JENNIFER",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-11",
"last_updated": "2008-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MA",
"license": "2831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woburn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 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.