Provider Demographics
NPI:1306371729
Name:KREMER, LARISA (OTR/L)
Entity Type:Individual
Prefix:
First Name:LARISA
Middle Name:
Last Name:KREMER
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 1:1800 E 12TH ST
Mailing Address - Street 2:APT 1C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1063
Mailing Address - Country:US
Mailing Address - Phone:347-753-1215
Mailing Address - Fax:
Practice Address - Street 1:1800 E 12TH ST
Practice Address - Street 2:APT 1C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1063
Practice Address - Country:US
Practice Address - Phone:347-753-1215
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-23
Last Update Date:2017-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021371-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist