Provider Demographics
NPI:1043396898
Name:BURTON, JUDYTHE ARLENE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:JUDYTHE
Middle Name:ARLENE
Last Name:BURTON
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 E TRYON AVE
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-6131
Mailing Address - Country:US
Mailing Address - Phone:201-833-2640
Mailing Address - Fax:718-918-7906
Practice Address - Street 1:1400 PELHAM PKWY S
Practice Address - Street 2:REHABILITATION MEDICINE J-213
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1138
Practice Address - Country:US
Practice Address - Phone:718-918-6204
Practice Address - Fax:718-918-7906
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001334-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist