Regina Vetack, COTA

Individual provider Active NPI Occupational Therapy Assistant · Westhampton, NY

NPI 1508067612 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1508067612
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapy Assistant 224Z00000X
License
004042-1 (NY)
Practice address
78 Old Country Rd
Westhampton, NY 11977-1219
Phone
(631) 288-0101
NPI assigned
May 29, 2007
Sex
Female
Sole proprietor
No

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
004042-1NYMDOccupational Therapy Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 004042-1 NY Yes

Addresses

Primary practice location

78 Old Country Rd
Westhampton, NY 11977-1219

Mailing address

32 Bass CT
Manorville, NY 11949-2609
Phone (516) 314-3984

Other providers in Westhampton, NY

All providers in Westhampton, NY · Occupational Therapy Assistant in New York

Sources for this page

Verify at the official NPI Registry.