Provider Demographics
NPI:1598359648
Name:WARSHAVSKY, PAMELA (MSOT, OTR/L)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:WARSHAVSKY
Suffix:
Gender:F
Credentials:MSOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 KINGS LN
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-1210
Mailing Address - Country:US
Mailing Address - Phone:516-713-8615
Mailing Address - Fax:
Practice Address - Street 1:1811 HONE AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1406
Practice Address - Country:US
Practice Address - Phone:718-518-1133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY02521501225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist