Healthcare Provider Details

I. General information

NPI: 1184535825
Provider Name (Legal Business Name): REBECCA NUSSBAUM OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 NEWTOWN RD STE 102
PLAINVIEW NY
11803-4317
US

IV. Provider business mailing address

245 NEWTOWN RD STE 102
PLAINVIEW NY
11803-4317
US

V. Phone/Fax

Practice location:
  • Phone: 516-802-2518
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number031429
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: