Active NPI
Nicole M Dean, MS, PT
- Physical Therapist
- Manorville, NY
National Provider Identifier
1891916581
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 017379-1
- Practice address
- 5 Tee View CT
Manorville, NY 11949-2939 - Phone
- (631) 874-3032
- Fax
- (631) 874-4105
- NPI assigned
- May 1, 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 017379-1 | NY | Primary |
Addresses
Primary practice location
5 Tee View CT
Manorville, NY 11949-2939
Mailing address
155 Parkwood Rd
West Islip, NY 11795
Phone (631) 669-3914
Other names 1
- Nicole M Matteo
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 |
|---|---|---|---|
| 017379-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1891916581",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 PARKWOOD RD",
"city": "WEST ISLIP",
"state": "NY",
"postal_code": "11795",
"telephone_number": "631-669-3914",
"fax_number": "631-669-3914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 TEE VIEW CT",
"city": "MANORVILLE",
"state": "NY",
"postal_code": "119492939",
"telephone_number": "631-874-3032",
"fax_number": "631-874-4105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEAN",
"first_name": "NICOLE",
"middle_name": "M",
"credential": "MS, PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "017379-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NICOLE",
"last_name": "MATTEO",
"middle_name": "M",
"credential": "MS, PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Manorville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.