Provider Demographics
NPI:1073949673
Name:NEWBERGER, SHERYL A (OTR/L, MA)
Entity Type:Individual
Prefix:
First Name:SHERYL
Middle Name:A
Last Name:NEWBERGER
Suffix:
Gender:F
Credentials:OTR/L, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 GREENWOOD AVE APT 3D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-1332
Mailing Address - Country:US
Mailing Address - Phone:847-757-3607
Mailing Address - Fax:
Practice Address - Street 1:800 GREENWOOD AVE APT 3D
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-1332
Practice Address - Country:US
Practice Address - Phone:847-757-3607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017856225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
463640630OtherEMPLOYER IDENTIFICATION NUMBER