Marley Nissenbaum, OTD
Occupational Therapist in Ellington, Connecticut
1487539995- Practice location
- 140 West RD Ste B, Ellington, CT 06029-5710
- Phone
- 860-872-7500
- Fax
- 860-872-7501
- Last updated
- June 17, 2026
Marley Nissenbaum is an Occupational Therapist based in Ellington, CT. Marley Nissenbaum practices in Ellington, CT and has the professional credentials of OTD. The NPI Number for Marley Nissenbaum is 1487539995 and holds a License No. OTL36304 (MA). The current practice location address for Marley Nissenbaum is 140 West RD Ste B, Ellington, CT 06029-5710 and can be reached out via phone at 860-872-7500 and via fax at 860-872-7501.
Provider Profile Details
- NPI Number
- 1487539995
- Provider Name
- Marley Nissenbaum
- Credential
- OTD
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 140 West RD Ste B, Ellington, CT 06029-5710
- Phone Number
- 860-872-7500
- Fax Number
- 860-872-7501
- Primary Taxonomy
- Occupational Therapist · 225X00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- August 6, 2025
- Last Update Date
- June 17, 2026
- Certification Date
- June 17, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 140 West RD Ste B
Ellington, CT 06029-5710 - City
- Ellington
- State
- Connecticut
- Zip
- 06029-5710
- Phone Number
- 860-872-7500
- Fax Number
- 860-872-7501
Provider Business Mailing Address Details
- Address
- 435 Hartford Tpke Ste U
Vernon, CT 06066-4834 - City
- Vernon
- State
- CT
- Zip
- 06066-4834
- Phone Number
- 860-872-7500
- Fax Number
- 860-872-7501
License Information
- License Number (1)
- OTL36304
- License State (1)
- MA
- Taxonomy (1)
- Occupational Therapist · 225X00000X
- License Number (2)
- 6902
- License State (2)
- CT
- Taxonomy (2)
- Occupational Therapist · 225X00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Marley Nissenbaum, OTD?
The NPI number of Marley Nissenbaum, OTD is 1487539995. It was assigned on August 6, 2025 and is currently active in the NPPES registry.
What is the specialty of Marley Nissenbaum, OTD?
Marley Nissenbaum, OTD is registered under the primary taxonomy Occupational Therapist (code 225X00000X), licensed in MA under license number OTL36304.
Where does Marley Nissenbaum, OTD practice?
The practice location is 140 West RD Ste B, Ellington, CT 06029-5710. The office can be reached at 860-872-7500 (phone) or 860-872-7501 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1487539995 directly on the NPPES registry website.