Provider Demographics
NPI:1679248181
Name:OBERTING, STEPHANIE (COTA/L)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:OBERTING
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 HUDSON AVE APT B
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12210-1803
Mailing Address - Country:US
Mailing Address - Phone:518-229-7552
Mailing Address - Fax:
Practice Address - Street 1:10B MADISON AVENUE EXT
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-7314
Practice Address - Country:US
Practice Address - Phone:518-229-7552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant