Provider Demographics
NPI:1427590777
Name:MYRTHIL, VALERIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:MYRTHIL
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 1:10 LAURA DR
Mailing Address - Street 2:
Mailing Address - City:WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11590-2810
Mailing Address - Country:US
Mailing Address - Phone:917-617-3647
Mailing Address - Fax:
Practice Address - Street 1:10 LAURA DR
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-2810
Practice Address - Country:US
Practice Address - Phone:917-617-3647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019984225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist