Alisa Dominique Fosmire, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

024168 Issued in NY

Practice address

750 E Adams St
Syracuse, NY 13210-2306

Phone

(315) 464-2302

NPI assigned

Oct 28, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1572220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1861035321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8848 MIDLAKE MEADOWS DR",
            "city": "BRIDGEPORT",
            "state": "NY",
            "postal_code": "130309726",
            "telephone_number": "520-309-5946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-2302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4900 Broad Rd",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132152265",
            "country_code": "US",
            "telephone_number": "315-492-5011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOSMIRE",
        "first_name": "ALISA",
        "middle_name": "DOMINIQUE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-28",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "024168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marisa Ann Fortino, MSW
• Pamela Jean Fortino, LCSW
• Christopher Neil Fortner, MD, PHD
• Amanda Sue Fortuna, OT RL
• John B Fortune, MD
• Chelsea Marie Foster, MD
• Mary Margaret Foster, NP
• Maureen E Foster, OTR/L
• Catherine Fowkes, OT
• Deidre Fowler, M.A., CCC-SLP

• Occupational Therapist in Syracuse, NY
• Providers in Syracuse, 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 Oct 28, 2019; 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.