Provider Demographics
NPI:1538494778
Name:KIRSCH DLUGACZ, STACY (MS, OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:STACY
Middle Name:
Last Name:KIRSCH DLUGACZ
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 IRVING PL
Mailing Address - Street 2:
Mailing Address - City:NEW ROCHELLE
Mailing Address - State:NY
Mailing Address - Zip Code:10801-1512
Mailing Address - Country:US
Mailing Address - Phone:516-313-2974
Mailing Address - Fax:
Practice Address - Street 1:150 W 92ND ST
Practice Address - Street 2:BB
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-7516
Practice Address - Country:US
Practice Address - Phone:212-595-1705
Practice Address - Fax:212-595-1706
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015760-1225XP0200X
NY015760225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics