Healthcare Provider Details

I. General information

NPI: 1922315746
Provider Name (Legal Business Name): MEREDITH STAUFFER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2010
Last Update Date: 09/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

473 FDR DR
NEW YORK NY
10002-2024
US

IV. Provider business mailing address

344 MCGUINNESS BLVD APT 2L
BROOKLYN NY
11222-1238
US

V. Phone/Fax

Practice location:
  • Phone: 212-475-2000
  • Fax: 212-475-2021
Mailing address:
  • Phone: 207-776-3679
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number016150-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: