Provider Demographics
NPI:1093594293
Name:BEISIEGEL, CAROLYN EMILY (COTA/L)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:EMILY
Last Name:BEISIEGEL
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 CHIMNEY RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HARRIMAN
Mailing Address - State:NY
Mailing Address - Zip Code:10926-3617
Mailing Address - Country:US
Mailing Address - Phone:845-825-3903
Mailing Address - Fax:
Practice Address - Street 1:5 CHIMNEY RIDGE DR
Practice Address - Street 2:
Practice Address - City:HARRIMAN
Practice Address - State:NY
Practice Address - Zip Code:10926-3617
Practice Address - Country:US
Practice Address - Phone:845-825-3903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-26
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011071224Z00000X
CT49.002262224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant