Provider Demographics
NPI:1417728825
Name:GIRDUSKY, SINEAD ANN I (OTR/L)
Entity Type:Individual
Prefix:
First Name:SINEAD
Middle Name:ANN
Last Name:GIRDUSKY
Suffix:I
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 1:8341 60TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-5442
Mailing Address - Country:US
Mailing Address - Phone:917-533-0064
Mailing Address - Fax:
Practice Address - Street 1:8341 60TH AVE
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-5442
Practice Address - Country:US
Practice Address - Phone:917-533-0064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028785225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist