Provider Demographics
NPI:1093955114
Name:MEHLMAN, MIRIAM (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:
Last Name:MEHLMAN
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 1:13645 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2327
Mailing Address - Country:US
Mailing Address - Phone:718-520-0561
Mailing Address - Fax:
Practice Address - Street 1:7014 141ST ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1931
Practice Address - Country:US
Practice Address - Phone:718-972-0880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-02
Last Update Date:2009-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006752-1172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker