Healthcare Provider Details

I. General information

NPI: 1720314321
Provider Name (Legal Business Name): KRISTINA MARIE BEGENT OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. KRISTINA MARIE OLIVEIRA

II. Dates (important events)

Enumeration Date: 11/02/2009
Last Update Date: 12/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 W ROE BLVD
PATCHOGUE NY
11772-2569
US

IV. Provider business mailing address

100 ROBINSON AVE
EAST PATCHOGUE NY
11772-4841
US

V. Phone/Fax

Practice location:
  • Phone: 631-742-5472
  • Fax: 631-627-8533
Mailing address:
  • Phone: 631-742-5472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: