Provider Demographics
NPI:1679220412
Name:AMERI, SAEIDEH T
Entity Type:Individual
Prefix:
First Name:SAEIDEH
Middle Name:T
Last Name:AMERI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-2340
Mailing Address - Country:US
Mailing Address - Phone:917-608-8900
Mailing Address - Fax:
Practice Address - Street 1:60 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-2340
Practice Address - Country:US
Practice Address - Phone:917-608-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-02
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011020224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant