Nova OT PC

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

018931 Issued in NY

Legal business name

NOVA OT PC

Practice address

9805 63Rd Rd
5B
Rego Park, NY 11374-1744

Phone

(917) 679-2040

NPI assigned

Feb 15, 2016

Last updated

Feb 15, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nelli BardanovaNPI 1740694587

Title

President

Phone

(917) 679-2040

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nelli Bardanova

  • Occupational Therapist
  • Middle Village, NY
  • NPI 1740694587
  Authorized official Same address or phone

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455494400000",
    "number": "1962861211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9805 63RD RD",
            "address_2": "5B",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741744",
            "telephone_number": "917-679-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9805 63RD RD",
            "address_2": "5B",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113741744",
            "telephone_number": "917-679-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA OT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-15",
        "last_updated": "2016-02-15",
        "status": "A",
        "authorized_official_last_name": "BARDANOVA",
        "authorized_official_first_name": "NELLI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-679-2040"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NY",
            "license": "018931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Rehabilitation Occupational Therapist in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Physical Rehabilitation Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2016; 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.