Active NPI
Jennifer Antelo-Justiniano
- Occupational Therapist
- Middle Island, NY
National Provider Identifier
1750767943
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 020301
- Practice address
- 35 Longwood Road
Middle Island, NY 11776 - Phone
- (631) 924-0008
- Fax
- (631) 924-1243
- NPI assigned
- Aug 11, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | P98699 | NY | |
| Occupational Therapist | 225X00000X | 020301 | NY | Primary |
Addresses
Primary practice location
35 Longwood Road
Middle Island, NY 11776
Mailing address
35 Longwood Road
Middle Island, NY 11953
Phone (631) 924-0008
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 |
|---|---|---|---|
| P98699 | NY | MD | Occupational Therapist |
| 020301 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1439251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459814400000",
"number": "1750767943",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 LONGWOOD ROAD",
"city": "MIDDLE ISLAND",
"state": "NY",
"postal_code": "11953",
"telephone_number": "631-924-0008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 LONGWOOD ROAD",
"city": "MIDDLE ISLAND",
"state": "NY",
"postal_code": "11776",
"telephone_number": "631-924-0008",
"fax_number": "631-924-1243"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANTELO-JUSTINIANO",
"first_name": "JENNIFER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-08-11",
"last_updated": "2016-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "P98699",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "020301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Middle Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.