Provider Demographics
NPI:1144620527
Name:ROSENFELD, DAVID IAN (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:IAN
Last Name:ROSENFELD
Suffix:
Gender:M
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 1:8062 210TH ST
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11427-1011
Mailing Address - Country:US
Mailing Address - Phone:212-987-9244
Mailing Address - Fax:646-304-1700
Practice Address - Street 1:8062 210TH ST
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11427-1011
Practice Address - Country:US
Practice Address - Phone:212-987-9244
Practice Address - Fax:646-304-1700
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-03
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007238225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics