Provider Demographics
NPI:1316601057
Name:SPENCER, SASHA NOHEMI (MS OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:SASHA
Middle Name:NOHEMI
Last Name:SPENCER
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 PROVOST PL
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-5001
Mailing Address - Country:US
Mailing Address - Phone:914-703-5412
Mailing Address - Fax:
Practice Address - Street 1:980 PEMART AVE
Practice Address - Street 2:
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-2210
Practice Address - Country:US
Practice Address - Phone:917-402-1228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-28
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026188225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY449769OtherNBCOT