Healthcare Provider Details

I. General information

NPI: 1982970299
Provider Name (Legal Business Name): ELIZABETH ANN HARNETT MS, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2012
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 IRISH CAPE RD
NAPANOCH NY
12458-2716
US

IV. Provider business mailing address

26 RESERVOIR RD
STAATSBURG NY
12580-5317
US

V. Phone/Fax

Practice location:
  • Phone: 845-392-0253
  • Fax:
Mailing address:
  • Phone: 845-392-0253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number017291
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: