Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dominique Bassallo, OT

Individual provider Occupational Therapist · NPI 1972437549

Dominique Bassallo, OT is an Occupational Therapist in Private Practice in Latham, New York. Qualified in 2025, 1 year ago. Licensed in New York.

Years since qualifying
1
Licensed in
NY
In the registry since
2026
What do these letters mean?
OT — Occupational Therapist
Helps people regain the skills needed for daily living and work.

See every abbreviation used in this directory →

Practice location Address checks out

711 Troy Schenectady Rd Ste 216
Latham, NY 12110-2461
Phone: (518) 786-1667
Fax: (518) 786-1954
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 031090 (NY)

Record details

NPI number1972437549
Entity typeIndividual (Type 1)
GenderFemale
Credentials OT
Sole proprietorNo
NPI enumeratedJune 10, 2026
Last updated in NPPESJune 10, 2026
Certification dateJune 10, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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