Healthcare Provider Details

I. General information

NPI: 1942112529
Provider Name (Legal Business Name): BETH ANNE ABT OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 HILLSDALE AVE
HILLSDALE NJ
07642-1103
US

IV. Provider business mailing address

98 VILLAGE GRN
BARDONIA NY
10954-2040
US

V. Phone/Fax

Practice location:
  • Phone: 201-664-4512
  • Fax:
Mailing address:
  • Phone: 845-304-6183
  • Fax: 845-638-3330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License NumberT6TR00017100
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: