Active NPI
Ellen Modlin, OTR
- Occupational Therapist
- Great Neck, NY
National Provider Identifier
1942453998
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 007537
- Practice address
- 55 Blue Bird Dr
Great Neck, NY 11023-1001 - Phone
- (917) 771-4932
- NPI assigned
- Nov 3, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 | 007537 | NY | Primary |
Addresses
Primary practice location
55 Blue Bird Dr
Great Neck, NY 11023-1001
Mailing address
55 Blue Bird Dr
Great Neck, NY 11023-1001
Phone (917) 771-4932
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 |
|---|---|---|---|
| 007537 | NY | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225670400000",
"number": "1942453998",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 BLUE BIRD DR",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110231001",
"telephone_number": "917-771-4932"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 BLUE BIRD DR",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110231001",
"telephone_number": "917-771-4932"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODLIN",
"first_name": "ELLEN",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-11-03",
"last_updated": "2008-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "007537",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.