Healthcare Provider Details

I. General information

NPI: 1750207411
Provider Name (Legal Business Name): AMANDA PEREZ OTD, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S BEDFORD RD
MOUNT KISCO NY
10549-3439
US

IV. Provider business mailing address

17 VAN HORN CIR APT B
BEACON NY
12508-1122
US

V. Phone/Fax

Practice location:
  • Phone: 914-421-8270
  • Fax:
Mailing address:
  • Phone: 845-541-1717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number030139
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: