Healthcare Provider Details

I. General information

NPI: 1356586820
Provider Name (Legal Business Name): MICHELLE ADLER OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2008
Last Update Date: 12/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 SAGAMORE DR
PLAINVIEW NY
11803-1516
US

IV. Provider business mailing address

63 SAGAMORE DR
PLAINVIEW NY
11803
US

V. Phone/Fax

Practice location:
  • Phone: 917-763-6144
  • Fax:
Mailing address:
  • Phone: 917-763-6144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number009983-1
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: