Individual provider Active NPI

Mary Ann Viscusi

  • Occupational Therapy Assistant
  • Lindenhurst, NY
National Provider Identifier
1932458601
Registry record updated Sep 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
004768 Issued in NY
Practice address
180 Albany Ave
Lindenhurst, NY 11757-2938
Phone
(631) 867-3250
NPI assigned
Sep 10, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 004768 NY Primary

Addresses

Primary practice location

180 Albany Ave
Lindenhurst, NY 11757-2938

Mailing address

1404 Gotham CT W
Saint James, NY 11780-3356
Phone (631) 686-5280

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

LicenseStateTypeSpecialty
004768NYMDOptician

NPI Registry JSON

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347235200000",
    "number": "1932458601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 GOTHAM CT W",
            "city": "SAINT JAMES",
            "state": "NY",
            "postal_code": "117803356",
            "telephone_number": "631-686-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 ALBANY AVE",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117572938",
            "telephone_number": "631-867-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISCUSI",
        "first_name": "MARY ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-10",
        "last_updated": "2012-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "004768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lindenhurst, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.

Verify at the official NPI Registry.