Provider Demographics
NPI:1437423811
Name:NAWOTNIAK, STEPHEN (OTR/L, NYCPS)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:
Last Name:NAWOTNIAK
Suffix:
Gender:M
Credentials:OTR/L, NYCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 TRANQUILITY TRL
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NY
Mailing Address - Zip Code:14086-1525
Mailing Address - Country:US
Mailing Address - Phone:585-490-1511
Mailing Address - Fax:
Practice Address - Street 1:7 TRANQUILITY TRL
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:NY
Practice Address - Zip Code:14086-1525
Practice Address - Country:US
Practice Address - Phone:585-490-1511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-01
Last Update Date:2020-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016413-1225XM0800X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XM0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistMental Health