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1639122948 NPI number — ELISSA MICHELE FIORITO OTR/L, CLT-LANA

NPI Number: 1639122948
Health Care Provider/Practitioner: ELISSA MICHELE FIORITO OTR/L, CLT-LANA

Information about “1639122948” NPI (ELISSA MICHELE FIORITO OTR/L, CLT-LANA) exists in 1639122948 in HTML format HTML  |  1639122948 in plain Text format TXT  |  1639122948 in PDF (Portable Document Format) PDF  |  1639122948 in an XML format XML  formats.

NPI Number : 1639122948 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1639122948",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "X",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FIORITO",
    "FirstName": "ELISSA",
    "MiddleName": "MICHELE",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "OTR/L, CLT-LANA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "305 PROVINCIAL DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MORGANVILLE",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "07751-4163",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "732-591-1685",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "240 WALL ST",
    "SecondLinePracticeLocationAddress": "SUITE 100",
    "PracticeLocationAddressCityName": "WEST LONG BRANCH",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "07764-1181",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "732-222-8556",
    "PracticeLocationAddressFaxNumber": "732-222-8663",
    "EnumerationDate": "05/18/2006",
    "LastUpdateDate": "07/08/2007",
    "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": "46TR00074700",
        "LicenseNumberStateCode": "NJ",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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