Susan Frisenda

Individual provider Active NPI Occupational Therapy Assistant · Red Hook, NY

NPI 1104105253 · NPPES record last updated Aug 8, 2011

Key facts

NPI
1104105253
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
005088-1 (NY)
Practice address
40 Devereux Way
Red Hook, NY 12571-2268
Phone
(845) 758-1899
NPI assigned
Aug 8, 2011
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
005088-1NYMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 005088-1 NY Yes

Addresses

Primary practice location

40 Devereux Way
Red Hook, NY 12571-2268

Mailing address

22 Rock City Rd
Milan, NY 12571-2439

Other providers in Red Hook, NY

All providers in Red Hook, NY · Occupational Therapy Assistant in New York

Sources for this page

Verify at the official NPI Registry.