Active NPI
Colleen Marie Pandolfino, MS,OTR/L
- Occupational Therapist
- Hamburg, NY
National Provider Identifier
1881873578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 012294-1
- Practice address
- 4650 Southwestern Blvd
Hamburg, NY 14075-1939 - Phone
- (716) 646-7423
- Fax
- (716) 648-7585
- NPI assigned
- Oct 30, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 012294-1 | NY | Primary |
Addresses
Primary practice location
4650 Southwestern Blvd
Hamburg, NY 14075-1939
Mailing address
4650 Southwestern Blvd
Hamburg, NY 14075-1939
Phone (716) 646-7423
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012294-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193702400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195084800000",
"number": "1881873578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4650 SOUTHWESTERN BLVD",
"city": "HAMBURG",
"state": "NY",
"postal_code": "140751939",
"telephone_number": "716-646-7423",
"fax_number": "716-648-7585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4650 SOUTHWESTERN BLVD",
"city": "HAMBURG",
"state": "NY",
"postal_code": "140751939",
"telephone_number": "716-646-7423",
"fax_number": "716-648-7585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PANDOLFINO",
"first_name": "COLLEEN",
"middle_name": "MARIE",
"credential": "MS,OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-30",
"last_updated": "2007-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "012294-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hamburg, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.