Healthcare Provider Details

I. General information

NPI: 1144013780
Provider Name (Legal Business Name): AVA SCHIRALDI OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2025
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

445 FOREST AVE
STATEN ISLAND NY
10301-2638
US

IV. Provider business mailing address

553 LAMOKA AVE
STATEN ISLAND NY
10312-3434
US

V. Phone/Fax

Practice location:
  • Phone: 718-979-5678
  • Fax:
Mailing address:
  • Phone: 917-434-1027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number030184
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: