Provider Demographics
NPI:1477979888
Name:NASH, NENA LYNNE (BS/OTR)
Entity Type:Individual
Prefix:MRS
First Name:NENA
Middle Name:LYNNE
Last Name:NASH
Suffix:
Gender:F
Credentials:BS/OTR
Other - Prefix:
Other - First Name:NENA
Other - Middle Name:LYNNE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS /OTR
Mailing Address - Street 1:404 THAYER ST
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13210-3700
Mailing Address - Country:US
Mailing Address - Phone:315-956-1611
Mailing Address - Fax:
Practice Address - Street 1:159 W 1ST ST
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-2045
Practice Address - Country:US
Practice Address - Phone:315-342-9575
Practice Address - Fax:315-342-7664
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006857225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist