Active NPI
Nicole Marie Diblasi, M.S. OTR/L
- Occupational Therapist
- Staten Island, NY
National Provider Identifier
1780995514
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 016071-1
- Practice address
- 236 Lyndale Ave
Staten Island, NY 10312-5542 - Phone
- (347) 983-4518
- NPI assigned
- Jun 25, 2010
- Last updated
- Sep 13, 2019
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 016071-1 | NY | Primary |
Addresses
Primary practice location
236 Lyndale Ave
Staten Island, NY 10312-5542
Mailing address
369 Genesee Ave
Staten Island, NY 10312-3201
Phone (347) 983-4518
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016071-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568332800000",
"number": "1780995514",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "369 GENESEE AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103123201",
"telephone_number": "347-983-4518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "236 LYNDALE AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103125542",
"telephone_number": "347-983-4518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIBLASI",
"first_name": "NICOLE",
"middle_name": "MARIE",
"credential": "M.S. OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-25",
"last_updated": "2019-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "016071-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.