Provider Demographics
NPI:1598919482
Name:VASSEL, ANNE BOLTON (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:BOLTON
Last Name:VASSEL
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 1:56 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-5818
Mailing Address - Country:US
Mailing Address - Phone:516-625-6600
Mailing Address - Fax:516-706-0735
Practice Address - Street 1:56 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-5818
Practice Address - Country:US
Practice Address - Phone:516-625-6600
Practice Address - Fax:516-706-0735
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011984225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist