Susan E. Young OT PC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

005988-1 Issued in NY

Legal business name

SUSAN E. YOUNG OT PC

Practice address

11 Stillwater Ave
Massapequa, NY 11758-8419

Phone

(516) 582-9034

Fax

(516) 799-1359

NPI assigned

May 21, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Susan E. Young, OT

Title

President

Phone

(516) 582-9034

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337558400000",
    "number": "1780944041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 STILLWATER AVE",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117588419",
            "telephone_number": "516-582-9034",
            "fax_number": "516-799-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 STILLWATER AVE",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117588419",
            "telephone_number": "516-582-9034",
            "fax_number": "516-799-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN E. YOUNG OT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-21",
        "last_updated": "2012-05-21",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-582-9034",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "005988-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Massapequa, NY
• Providers in Massapequa, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.