Active NPI
Gabriella Nussbaum, MOT, OTR/L
- Occupational Therapist
- Edison, NJ
National Provider Identifier
1881948453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 017656-1
- Practice address
- 10 Brookfall Rd
Edison, NJ 08817-2947 - Phone
- (732) 777-0193
- NPI assigned
- Nov 5, 2012
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 46TR00596500 | NJ | |
| Occupational Therapist | 225X00000X | 017656-1 | NY | Primary |
| Occupational Therapist | 225X00000X | 07021 | MD |
Addresses
Primary practice location
10 Brookfall Rd
Edison, NJ 08817-2947
Mailing address
10 Brookfall Rd
Edison, NJ 08817-2947
Phone (732) 777-0193
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
| License | State | Type | Specialty |
|---|---|---|---|
| 46TR00596500 | NJ | MD | Occupational Therapist |
| 017656-1 | NY | MD | Occupational Therapist |
| 07021 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352073600000",
"number": "1881948453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 BROOKFALL RD",
"city": "EDISON",
"state": "NJ",
"postal_code": "088172947",
"telephone_number": "732-777-0193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 BROOKFALL RD",
"city": "EDISON",
"state": "NJ",
"postal_code": "088172947",
"telephone_number": "732-777-0193"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUSSBAUM",
"first_name": "GABRIELLA",
"credential": "MOT, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-05",
"last_updated": "2012-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NJ",
"license": "46TR00596500",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "017656-1",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MD",
"license": "07021",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Edison, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.