Keith M Van Tassell, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

010331-1 Issued in NY

Practice address

243 Demorest Ave
Staten Island, NY 10314-3160

Phone

(718) 447-1414

NPI assigned

Jan 2, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1230854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230854400000",
    "number": "1962648568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 DEMOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143160",
            "telephone_number": "718-447-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 DEMOREST AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143160",
            "telephone_number": "718-447-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN TASSELL",
        "first_name": "KEITH",
        "middle_name": "M",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-02",
        "last_updated": "2009-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "010331-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Valvo
• Christine Van Cott
• Kimberly Andrea Van Osten
• Brittany Van Staalduinen
• Amanda Van Tassell, M.S., CF-SLP
• Lisa A Van Tassell, OTR/L
• Melinda Vancleaf, MSED
• David L Vancott, D.D.S.
• Patricia Vander Neut, MS. CCC-SLP
• Ebenezer Vander Pallen, RN

• Pediatric Occupational Therapist in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Pediatric Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2009; 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.