=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902034838
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TERRI SPERBER MA/OTR/L
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/30/2009
-----------------------------------------------------
Last Update Date | 02/16/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 130 N CENTRAL AVE OCCUPATIONAL THERAPY
-----------------------------------------------------
City | HARTSDALE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10530-1910
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-952-4155
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 36 MAPLE AVE OCCUPATIONAL THERAPY
-----------------------------------------------------
City | HASTINGS ON HUDSON
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10706-1404
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-952-4155
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 008133-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225X00000X
-----------------------------------------------------
Taxonomy Name | Occupational Therapist
-----------------------------------------------------
License Number | 03-581826
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------