Active NPI
Brandie Mura, MS, OTR/L
- Occupational Therapist
- Kenmore, NY
National Provider Identifier
1962751479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 017103-1
- Practice address
- 3767 Delaware Ave
Kenmore, NY 14217-1040 - Phone
- (716) 847-6175
- NPI assigned
- Aug 30, 2012
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 017103-1 | NY | Primary |
Addresses
Primary practice location
3767 Delaware Ave
Kenmore, NY 14217-1040
Mailing address
3767 Delaware Ave
Kenmore, NY 14217-1040
Phone (716) 698-1173
Other practice location 1
2039 George urban Blvd
Depew, NY 14043
Phone (716) 901-8700
Other practice location 2
44 Trowbridge Street
Buffalo, NY 14220
Phone (716) 698-1173
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 |
|---|---|---|---|
| 017103-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537228800000",
"number": "1962751479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3767 DELAWARE AVE",
"city": "KENMORE",
"state": "NY",
"postal_code": "142171040",
"telephone_number": "716-698-1173"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3767 DELAWARE AVE",
"city": "KENMORE",
"state": "NY",
"postal_code": "142171040",
"telephone_number": "716-847-6175"
}
],
"practiceLocations": [
{
"address_1": "2039 George urban Blvd",
"address_purpose": "LOCATION",
"city": "Depew",
"state": "NY",
"postal_code": "14043",
"country_code": "US",
"telephone_number": "716-901-8700",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "44 Trowbridge Street",
"address_purpose": "LOCATION",
"city": "Buffalo",
"state": "NY",
"postal_code": "14220",
"country_code": "US",
"telephone_number": "716-698-1173",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MURA",
"first_name": "BRANDIE",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-30",
"last_updated": "2018-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "017103-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenmore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.