Provider Demographics
NPI:1427198472
Name:STEWART, AILEEN M (OT)
Entity Type:Individual
Prefix:MISS
First Name:AILEEN
Middle Name:M
Last Name:STEWART
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ANTHONY LN
Mailing Address - Street 2:
Mailing Address - City:NORTH BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11703-4000
Mailing Address - Country:US
Mailing Address - Phone:631-661-6263
Mailing Address - Fax:631-661-4134
Practice Address - Street 1:6 ANTHONY LN
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-4000
Practice Address - Country:US
Practice Address - Phone:631-661-6263
Practice Address - Fax:631-661-4134
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0070121225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist