Perry Edward Lebreton, COTA, CBIS

Key facts

NPI

1730709403

Entity type

Individual (NPI type 1)

Primary specialty

Occupational Therapy Assistant 224Z00000X

License

OA2376 (ME)

Practice address

115 Pine St
Old Town, ME 04468-1713

Phone

(207) 907-9768

NPI assigned

Apr 22, 2020

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 22, 2020.

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1730709403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 PINE ST",
            "city": "OLD TOWN",
            "state": "ME",
            "postal_code": "044681713",
            "telephone_number": "207-907-9768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 PINE ST",
            "city": "OLD TOWN",
            "state": "ME",
            "postal_code": "044681713",
            "telephone_number": "207-907-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBRETON",
        "first_name": "PERRY",
        "middle_name": "EDWARD",
        "credential": "COTA, CBIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "ME",
            "license": "OA2376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alicia Marie Lacy, ATC
• Kathryn Elizabeth Lessard
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• Kayla Jo Maioriello

All providers in Old Town, ME · Occupational Therapy Assistant in Maine