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

Organization subpart

No

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

Authorized official

Name

Nelli Bardanova

Title

President

Phone

(917) 679-2040

Specialties & licenses 1

Addresses

Locations

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 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.