Individual provider Active NPI

Maria R Galvis Mantilla, O.T.R/L

  • Occupational Therapist
  • Rego Park, NY
National Provider Identifier
1982913521
Registry record updated Sep 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
006300 Issued in NY
Practice address
62-08 Ellwell Crescent
Rego Park, NY 11374
Phone
(718) 459-5459
NPI assigned
Sep 30, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 006300 NY Primary

Addresses

Primary practice location

62-08 Ellwell Crescent
Rego Park, NY 11374

Mailing address

62-08 Ellwell Crescent
Rego Park, NY 11374
Phone (718) 459-5459

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

NPI Registry JSON

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

{
    "created_epoch": "1285804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285804800000",
    "number": "1982913521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62-08 ELLWELL CRESCENT",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "11374",
            "telephone_number": "718-459-5459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62-08 ELLWELL CRESCENT",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "11374",
            "telephone_number": "718-459-5459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALVIS MANTILLA",
        "first_name": "MARIA",
        "middle_name": "R",
        "credential": "O.T.R/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-30",
        "last_updated": "2010-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "006300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2010; 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.