Individual provider Active NPI

Miriam Roth, OTR

  • Occupational Therapist
  • Lawrence, NY
National Provider Identifier
1912284894
Registry record updated Nov 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
010423 Issued in NY
Practice address
1049 New McNeil Ave
Lawrence, NY 11559-1725
Phone
(516) 242-5313
Fax
(718) 504-7125
NPI assigned
Nov 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 010423 NY Primary

Addresses

Primary practice location

1049 New McNeil Ave
Lawrence, NY 11559-1725

Mailing address

1049 New McNeil Ave
Lawrence, NY 11559-1725
Phone (516) 242-5313

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

NPI Registry JSON

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

{
    "created_epoch": "1320624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320624000000",
    "number": "1912284894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 NEW MCNEIL AVE",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591725",
            "telephone_number": "516-242-5313",
            "fax_number": "718-504-7125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 NEW MCNEIL AVE",
            "city": "LAWRENCE",
            "state": "NY",
            "postal_code": "115591725",
            "telephone_number": "516-242-5313",
            "fax_number": "718-504-7125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH",
        "first_name": "MIRIAM",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-07",
        "last_updated": "2011-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "010423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2011; 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.