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1043385230 NPI number — MICHELLE LYNN CASAB OTR L

NPI Number: 1043385230
Health Care Provider/Practitioner: MICHELLE LYNN CASAB OTR L

Information about “1043385230” NPI (MICHELLE LYNN CASAB OTR L) exists in 1043385230 in HTML format HTML  |  1043385230 in plain Text format TXT  |  1043385230 in PDF (Portable Document Format) PDF  |  1043385230 in an XML format XML  formats.

NPI Number : 1043385230 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1043385230",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "CASAB",
    "FirstName": "MICHELLE",
    "MiddleName": "LYNN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "OTR L",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "MADORE",
    "OtherFirstName": "MICHELLE",
    "OtherMiddleName": "LYNN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "9375 CHAPMAN RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NEW HARTFORD",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "13413-3705",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1500 N JAMES ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ROME",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "13440-2844",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "315-337-7952",
    "PracticeLocationAddressFaxNumber": "315-338-7417",
    "EnumerationDate": "11/22/2006",
    "LastUpdateDate": "03/08/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225X00000X",
        "TaxonomyName": "Occupational Therapist",
        "LicenseNumber": "010175-1",
        "LicenseNumberStateCode": "NY",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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