Provider Demographics
NPI:1275851453
Name:BENDZLOWICZ-VOGT, SHARON (OTR/L)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:
Last Name:BENDZLOWICZ-VOGT
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:CHRISTINA
Other - Last Name:BENDZLOWICZ-VOGT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:111 OVERHILL RD
Mailing Address - Street 2:
Mailing Address - City:WADING RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:11792-1614
Mailing Address - Country:US
Mailing Address - Phone:631-929-8232
Mailing Address - Fax:
Practice Address - Street 1:111 OVERHILL RD
Practice Address - Street 2:
Practice Address - City:WADING RIVER
Practice Address - State:NY
Practice Address - Zip Code:11792-1614
Practice Address - Country:US
Practice Address - Phone:631-929-8232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009104-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist