Provider Demographics
NPI:1497057525
Name:OSMENA, STELLA CONCHITINA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:STELLA CONCHITINA
Middle Name:
Last Name:OSMENA
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 1:4211 KETCHAM ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-2310
Mailing Address - Country:US
Mailing Address - Phone:646-249-8105
Mailing Address - Fax:
Practice Address - Street 1:301 E 29TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-8301
Practice Address - Country:US
Practice Address - Phone:212-722-0610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020497225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist