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General NPI Number Information
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NPI Number | 1609500388
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Entity Type | Individual
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Provider Name | SHIRA DISKIND OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/10/2022
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Last Update Date | 07/10/2022
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Provider Practice Location Address
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Address Line | 9 HEWLETT ST
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City | WATERBURY
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State | CT
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Zip | 06710-1616
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Country | US
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Telephone | 570-540-6395
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Fax |
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Provider Business Mailing Address
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Address Line | 3 ROSH DR APT B
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City | NAUGATUCK
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State | CT
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Zip | 06770-3482
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Country | US
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Telephone |
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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 |
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License Number State |
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