Krista Dendor Bryant
Individual provider Active NPI Pediatric Occupational Therapist · East Greenbush, NY
NPI 1831685338 · NPPES record last updated Sep 24, 2021
Key facts
- NPI
- 1831685338
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Occupational Therapist 225XP0200X
- License
- 022658 (NY)
- Practice address
- 673 Columbia Tpke
East Greenbush, NY 12061-2130 - Phone
- (518) 233-0544
- NPI assigned
- Jul 8, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200304000354 | NY | Practitioner - Occupational Therapist in Private Practice | 7719314772 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 022658 | NY | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas Nicolla Consulting Services, PLLC | Single Specialty | Current |
Accepting new patients |
| Nicolla and Associates, PT & OT Services, PLLC | Single Specialty | Current |
Accepting new patients |
| Capital District Beginnings | Past | Accepting new patients |
Locations
711 Troy Schenectady Rd
Ste 209
Latham, NY 12110
Phone (518) 786-1667
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist |
225XP0200X | 022658 | NY | Yes |
Addresses
Primary practice location
673 Columbia Tpke
East Greenbush, NY 12061-2130
Mailing address
35 Perry Ave
Latham, NY 12110-2433
Phone (518) 867-9731
Other practice location 1
711 Troy Schenectady Rd
Latham, NY 12110-2442
Phone (518) 786-1665
Other providers in East Greenbush, NY
- Denise Boniface
- Kelly Brambrick
- Nancy Brennan-Jordan
- Kristen Brown
- Amber Michelle Bruckner
- Megan Budwick
- Louie Ann Buhl
- Barbara Bureau
- Amy Lee Burelson
- Kaylea Burns
All providers in East Greenbush, NY · Pediatric Occupational Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.