Provider Demographics
NPI:1215400122
Name:KORNHABER, SHERLY (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:SHERLY
Middle Name:
Last Name:KORNHABER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:SHERLY
Other - Middle Name:
Other - Last Name:JOSEPH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1225 MORRIS PARK AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-1949
Mailing Address - Country:US
Mailing Address - Phone:718-839-7106
Mailing Address - Fax:
Practice Address - Street 1:1225 MORRIS PARK AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1949
Practice Address - Country:US
Practice Address - Phone:718-839-7106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-03
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0231841225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist