Provider Demographics
NPI:1326284118
Name:GRABER, AVIVA MICHELLE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:AVIVA
Middle Name:MICHELLE
Last Name:GRABER
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 1:588 CHURCH AVE
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2732
Mailing Address - Country:US
Mailing Address - Phone:516-239-4581
Mailing Address - Fax:
Practice Address - Street 1:588 CHURCH AVE
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-2732
Practice Address - Country:US
Practice Address - Phone:516-239-4581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-28
Last Update Date:2008-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012075225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics