Provider Demographics
NPI:1609013465
Name:PONDAR, HAYDEE (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:HAYDEE
Middle Name:
Last Name:PONDAR
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 1:7064 YELLOWSTONE BLVD
Mailing Address - Street 2:APT 1 B
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3563
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:260 MIDDLE COUNTRY RD
Practice Address - Street 2:BLDG 3 SUITE 9 A
Practice Address - City:SELDEN
Practice Address - State:NY
Practice Address - Zip Code:11784-2568
Practice Address - Country:US
Practice Address - Phone:631-732-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-15
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013832225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation