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General NPI Number Information
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NPI Number | 1134899578
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Entity Type | Individual
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Provider Name | STEPHANIE LEE ESPINO OTR/L
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Gender | Female
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 475 NORTHERN BLVD
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City | GREAT NECK
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State | NY
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Zip | 11021-4819
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Country | US
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Telephone | 718-206-5062
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Fax |
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Provider Business Mailing Address
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Address Line | 341 10TH ST APT 14E
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City | BROOKLYN
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State | NY
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Zip | 11215-3948
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Country | US
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Telephone | 718-304-6011
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 021966-01
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License Number State | NY
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