Individual provider Active NPI

Crystal Elizabeth Tangorra, OTR/L

  • Pediatric Occupational Therapist
  • Phoenix, NY
National Provider Identifier
1851536635
Registry record updated Dec 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
007337-1 Issued in NY
Practice address
9171 Tanwood Cir
Phoenix, NY 13135-3050
Phone
(315) 934-4046
NPI assigned
Dec 9, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 007337-1 NY Primary

Addresses

Primary practice location

9171 Tanwood Cir
Phoenix, NY 13135-3050

Mailing address

9171 Tanwood Cir
Phoenix, NY 13135-3050
Phone (315) 934-4046

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

LicenseStateTypeSpecialty
007337-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228780800000",
    "number": "1851536635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9171 TANWOOD CIR",
            "city": "PHOENIX",
            "state": "NY",
            "postal_code": "131353050",
            "telephone_number": "315-934-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9171 TANWOOD CIR",
            "city": "PHOENIX",
            "state": "NY",
            "postal_code": "131353050",
            "telephone_number": "315-934-4046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANGORRA",
        "first_name": "CRYSTAL",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-09",
        "last_updated": "2008-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "007337-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; 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.