Provider Demographics
NPI:1508010299
Name:HIRSHOWITZ, SUSAN BONNIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:BONNIE
Last Name:HIRSHOWITZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:BONNIE
Other - Middle Name:
Other - Last Name:HIRSHOWITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:16 DONALD DR
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10804-1802
Mailing Address - Country:US
Mailing Address - Phone:914-260-6870
Mailing Address - Fax:914-637-8275
Practice Address - Street 1:698 YONKERS AVE
Practice Address - Street 2:SUITE 1J
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-2689
Practice Address - Country:US
Practice Address - Phone:914-969-3016
Practice Address - Fax:914-969-3722
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-09
Last Update Date:2008-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004777-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist