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General NPI Number Information
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NPI Number | 1386899219
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Entity Type | Individual
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Provider Name | SANDRA BIGELOW OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/19/2008
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 44 W 74TH ST APT. 2D
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City | NEW YORK
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State | NY
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Zip | 10023-2451
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Country | US
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Telephone | 917-442-4749
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Fax |
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Provider Business Mailing Address
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Address Line | 5331 S MACADAM AVE STE 258, PMB 524
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City | PORTLAND
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State | OR
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Zip | 97239-2451
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Country | US
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Telephone | 917-442-4749
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 008475-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1014661
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License Number State | OR
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