Healthcare Provider Details

I. General information

NPI: 1669011623
Provider Name (Legal Business Name): BARBARA RUTH FLEISCHER OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/22/2019
Last Update Date: 12/22/2019
Certification Date: 12/22/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

82 CHELSEA ST
HAWTHORNE NY
10532-1732
US

IV. Provider business mailing address

82 CHELSEA ST
HAWTHORNE NY
10532-1732
US

V. Phone/Fax

Practice location:
  • Phone: 914-804-5648
  • Fax:
Mailing address:
  • Phone: 914-804-5648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number000328-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: