Provider Demographics
NPI:1194024851
Name:ATTERBURY, KAMANTHA SHERINA (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:KAMANTHA
Middle Name:SHERINA
Last Name:ATTERBURY
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 1:11222 FRANCIS LEWIS BLVD
Mailing Address - Street 2:
Mailing Address - City:QUEENS VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11429-2224
Mailing Address - Country:US
Mailing Address - Phone:347-592-8101
Mailing Address - Fax:
Practice Address - Street 1:11222 FRANCIS LEWIS BLVD
Practice Address - Street 2:
Practice Address - City:QUEENS VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11429-2224
Practice Address - Country:US
Practice Address - Phone:347-592-8101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor