Active NPI
Gwen Simon
- Occupational Therapist
- Roslyn Heights, NY
National Provider Identifier
1790178945
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 003856-1
- Practice address
- 139 Powerhouse Rd
Roslyn Heights, NY 11577-1915 - Phone
- (516) 426-8465
- NPI assigned
- Mar 12, 2015
- Last updated
- Mar 12, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | 003856-1 | NY | Primary |
Addresses
Primary practice location
139 Powerhouse Rd
Roslyn Heights, NY 11577-1915
Mailing address
139 Powerhouse Rd
Roslyn Heights, NY 11577-1915
Phone (516) 426-8465
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 |
|---|---|---|---|
| 003856-1 | NY | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426118400000",
"number": "1790178945",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "139 POWERHOUSE RD",
"city": "ROSLYN HEIGHTS",
"state": "NY",
"postal_code": "115771915",
"telephone_number": "516-426-8465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "139 POWERHOUSE RD",
"city": "ROSLYN HEIGHTS",
"state": "NY",
"postal_code": "115771915",
"telephone_number": "516-426-8465"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMON",
"first_name": "GWEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-03-12",
"last_updated": "2015-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "003856-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roslyn Heights, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.