Provider Demographics
NPI:1043547540
Name:MARGOLIS, TAMAR (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:TAMAR
Middle Name:
Last Name:MARGOLIS
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 1:111 CHARTER OAK AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-1912
Mailing Address - Country:US
Mailing Address - Phone:860-298-9079
Mailing Address - Fax:860-683-2398
Practice Address - Street 1:601 RIVER ST.
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06095-1325
Practice Address - Country:US
Practice Address - Phone:860-298-9079
Practice Address - Fax:860-683-2398
Is Sole Proprietor?:No
Enumeration Date:2009-11-04
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015879-1225X00000X
CT002539225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist