Active NPI
Elisa Kay Freire-Davis, OTR
- Contractor
- Huntington Station, NY
National Provider Identifier
1750420402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- 005600-1
- Practice address
- 44 Penny Dr
Huntington Station, NY 11746-3423 - Phone
- (631) 673-0930
- NPI assigned
- Feb 6, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Contractor | 171W00000X | 005600-1 | NY | Primary |
Addresses
Primary practice location
44 Penny Dr
Huntington Station, NY 11746-3423
Mailing address
44 Penny Dr
Huntington Station, NY 11746-3423
Phone (631) 673-0930
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 |
|---|---|---|---|
| 005600-1 | NY | MD | Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750420402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 PENNY DR",
"city": "HUNTINGTON STATION",
"state": "NY",
"postal_code": "117463423",
"telephone_number": "631-673-0930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 PENNY DR",
"city": "HUNTINGTON STATION",
"state": "NY",
"postal_code": "117463423",
"telephone_number": "631-673-0930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREIRE-DAVIS",
"first_name": "ELISA",
"middle_name": "KAY",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "NY",
"license": "005600-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington Station, NY
- Brenda Marie Forbes
- Mindy Fortgang, MSED
- Ma. Theresa Andaleon Francia-Ilao, PT
- Freedom Center of Huntington, LLC (Huntington Station Dialysis Center)
- Freedom Stairlifts LLC
- Nicole Staci Fridas, TSHH, MSED, PD - SAS
- Marsha Stacy Fried, O.D.
- Neil Fruchtman
- Paul J Fuccillo, L.AC. LMT MS MA
- Alan R Furman, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.