1881279305 NPI number — VICTORIA ANN SYRACUSA OTD, MSOT, OTR/L

NPI Number: 1881279305
Health Care Provider/Practitioner: VICTORIA ANN SYRACUSA OTD, MSOT, OTR/L

NPI Number : 1881279305 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1881279305",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SYRACUSA",
    "FirstName": "VICTORIA",
    "MiddleName": "ANN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "OTD, MSOT, OTR/L",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1316 KLEM RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WEBSTER",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "14580-8647",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1057 E HENRIETTA RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ROCHESTER",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "14623-2635",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "585-427-2977",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/16/2021",
    "LastUpdateDate": "03/18/2025",
    "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": "225XP0200X",
          "TaxonomyName": "Pediatric Occupational Therapist",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225XP0200X",
          "TaxonomyName": "Pediatric Occupational Therapist",
          "LicenseNumber": "025438",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}