Provider Demographics
NPI:1639126089
Name:BRANDLER, ALLISON (OTR/L MS)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:BRANDLER
Suffix:
Gender:F
Credentials:OTR/L MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:374 BEACH 12TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-5528
Mailing Address - Country:US
Mailing Address - Phone:516-382-7460
Mailing Address - Fax:
Practice Address - Street 1:374 BEACH 12TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-5528
Practice Address - Country:US
Practice Address - Phone:516-382-7460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2008-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014021-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist