Provider Demographics
NPI:1609020197
Name:LEGER, CAROLINE (MA OTR/L)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:LEGER
Suffix:
Gender:F
Credentials:MA OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 PENINSULA BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2835
Mailing Address - Country:US
Mailing Address - Phone:516-647-3677
Mailing Address - Fax:516-569-9247
Practice Address - Street 1:709 PENINSULA BLVD
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-2835
Practice Address - Country:US
Practice Address - Phone:516-647-3677
Practice Address - Fax:516-569-9247
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-10
Last Update Date:2008-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004157-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics