MEDICARE: HEATHER LEIGH TATTERSALL MS, MPH, OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1366876815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER LEIGH TATTERSALL MS, MPH, OTR/L

Provider Business Mailing Address
First Line	:	1355 2ND AVE APT 3A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-4558
Country	:	US
Telephone Number	:	302-593-9424
Fax Number	:

Provider Business Practice Location Address
First Line	:	1355 2ND AVE APT 3A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10021-4558
Country	:	US
Telephone Number	:	302-593-9424
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/01/2013
Last Update Date	:	01/29/2025

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