Provider Demographics
NPI:1033198023
Name:FEDERBUSCH, SHARI (MA, OTR, CHT)
Entity Type:Individual
Prefix:
First Name:SHARI
Middle Name:
Last Name:FEDERBUSCH
Suffix:
Gender:F
Credentials:MA, OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 CRAGMERE OVAL
Mailing Address - Street 2:
Mailing Address - City:NEW CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10956-5432
Mailing Address - Country:US
Mailing Address - Phone:845-638-2126
Mailing Address - Fax:
Practice Address - Street 1:151 N MAIN ST
Practice Address - Street 2:SUITE 302
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-3851
Practice Address - Country:US
Practice Address - Phone:845-638-2728
Practice Address - Fax:845-638-1830
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3201225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ75431Medicare PIN