Provider Demographics
NPI:1467019851
Name:BRUSCHINI, JULIANNE (OTR/L)
Entity Type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:BRUSCHINI
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 1:16 TAFT PL
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-1521
Mailing Address - Country:US
Mailing Address - Phone:516-672-0574
Mailing Address - Fax:
Practice Address - Street 1:50 GODFREY AVE
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11709-2710
Practice Address - Country:US
Practice Address - Phone:516-672-0574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021447225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist