Wal Occupational Therapy PC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

Legal business name

WAL OCCUPATIONAL THERAPY PC

Practice address

6865 Fresh Pond Rd
Ridgewood, NY 11385-5263

Phone

(917) 484-1465

Fax

(917) 900-1681

NPI assigned

Jan 10, 2023

Organization subpart

No

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

Authorized official

Name

Wilmer Lacson, PTNPI 1477881365

Title

President

Phone

(917) 484-1465

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wilmer Avancy Lacson

  • Occupational Therapist
  • Yonkers, NY
  • NPI 1477881365
  Medicare reassignment Authorized official
• Ryan Dinneny

  • Physical Therapy Clinic/Center
  • Staten Island, NY
  • NPI 1205337300
  Medicare reassignment NPD

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

{
    "created_epoch": "1673308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673308800000",
    "number": "1811601263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 E 108TH ST APT 3E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100294228",
            "telephone_number": "917-484-1465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6865 FRESH POND RD",
            "city": "RIDGEWOOD",
            "state": "NY",
            "postal_code": "113855263",
            "telephone_number": "917-484-1465",
            "fax_number": "917-900-1681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAL OCCUPATIONAL THERAPY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-10",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A",
        "authorized_official_last_name": "LACSON",
        "authorized_official_first_name": "WILMER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-484-1465",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amin Villaran, CASAC # 33961
• Danielle Vilsaint, FNP
• Amy Visintainer
• Vision World of Myrtle Avenue, Inc
• Vision World of Ridgewood Inc.
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Andrea Walkes

• Occupational Therapist in Ridgewood, NY
• Providers in Ridgewood, 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 Jan 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.