Ryan Divita, TEACHER

Primary specialty

Respiratory/Developmental/Rehabilitative Specialist/TechnologistTaxonomy code 225500000X

Practice address

26 San Fernando LN
East Amherst, NY 14051-2234

Phone

(716) 472-1289

Fax

(716) 689-2916

NPI assigned

Jun 8, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1811626419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 BRAMBLE CT",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142211715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 SAN FERNANDO LN",
            "city": "EAST AMHERST",
            "state": "NY",
            "postal_code": "140512234",
            "telephone_number": "716-472-1289",
            "fax_number": "716-689-2916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVITA",
        "first_name": "RYAN",
        "credential": "TEACHER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-08",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NY",
            "license": null,
            "primary": false
        },
        {
            "code": "225500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.creativetherapiesofwny.com",
            "affiliation": "N",
            "address_1": "26 San Fernando Ln",
            "city": "East Amherst",
            "state": "NY",
            "country_code": "US",
            "postal_code": "140512234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lauren Devantier
• Julia Jane Hart Dewey, PH.D.
• Renee Dire
• Mary Dittenhauser, LMT
• Diversified Rehabilitation Services
• Alyssa Dixon
• Domm Family Chiropractic, PLLC
• Donald Joseph Donius, MD
• Donald P Douglas, M.D.
• Nicolette R Dumansky

• Respiratory/Developmental/Rehabilitative Specialist/Technologist in East Amherst, NY
• Providers in East Amherst, NY by specialty
• Respiratory/Developmental/Rehabilitative Specialist/Technologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.