Provider Demographics
NPI:1093139834
Name:CALDERA, EVA ROSE SIMKIN (MSOTR/L)
Entity Type:Individual
Prefix:MRS
First Name:EVA
Middle Name:ROSE SIMKIN
Last Name:CALDERA
Suffix:
Gender:F
Credentials:MSOTR/L
Other - Prefix:
Other - First Name:EVA
Other - Middle Name:ROSE
Other - Last Name:SIMKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 W 105TH ST APT 2H
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-4030
Mailing Address - Country:US
Mailing Address - Phone:571-215-7116
Mailing Address - Fax:
Practice Address - Street 1:150 W 92ND ST APT BB
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-7556
Practice Address - Country:US
Practice Address - Phone:212-595-1705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-14
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018587225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist