Provider Demographics
NPI:1265686752
Name:MENDLOWITZ, MIRIAM S (OTR/L)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:S
Last Name:MENDLOWITZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:MIRIAM
Other - Middle Name:S
Other - Last Name:THALER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 WAYNE RD
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1408
Mailing Address - Country:US
Mailing Address - Phone:845-354-0225
Mailing Address - Fax:
Practice Address - Street 1:5 WAYNE RD
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-1408
Practice Address - Country:US
Practice Address - Phone:845-354-0225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014259-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist