Provider Demographics
NPI:1013591809
Name:SALAZAR, ISABEL ARDIS (OTR/L)
Entity Type:Individual
Prefix:
First Name:ISABEL
Middle Name:ARDIS
Last Name:SALAZAR
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-5700
Mailing Address - Country:US
Mailing Address - Phone:718-239-8239
Mailing Address - Fax:
Practice Address - Street 1:3175 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-5700
Practice Address - Country:US
Practice Address - Phone:718-239-8239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-08
Last Update Date:2021-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00987000225X00000X
CAOT22228225X00000X
NY025511225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist