Active NPI
Christopher Brian Blazer, OTR/L
- Occupational Therapist
- Long Island City, NY
National Provider Identifier
1770172900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 024766-01
- Practice address
- 240 51St Ave Apt 2G
Long Island City, NY 11101-5866 - Phone
- (609) 992-5464
- NPI assigned
- Jan 12, 2021
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 024766-01 | NY | Primary |
Addresses
Primary practice location
240 51St Ave Apt 2G
Long Island City, NY 11101-5866
Mailing address
240 51St Ave Apt 2G
Long Island City, NY 11101-5866
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024766 | NY | MD | Clinical Psychologist |
| 024766-01 | NY | MD | Occupational Therapist |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H1722
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1610409600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1610409600000",
"number": "1770172900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 51ST AVE APT 2G",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111015866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "240 51ST AVE APT 2G",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111015866",
"telephone_number": "609-992-5464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAZER",
"first_name": "CHRISTOPHER",
"middle_name": "BRIAN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-01-12",
"last_updated": "2021-01-12",
"certification_date": "2021-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "024766-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Island City, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 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.