Provider Demographics
NPI:1790117067
Name:STULBERGER, TOVA
Entity Type:Individual
Prefix:MRS
First Name:TOVA
Middle Name:
Last Name:STULBERGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TOVA
Other - Middle Name:
Other - Last Name:SHAPIRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14905 79TH AVE APT 514
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3874
Mailing Address - Country:US
Mailing Address - Phone:414-841-8902
Mailing Address - Fax:
Practice Address - Street 1:14905 79TH AVE APT 514
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3874
Practice Address - Country:US
Practice Address - Phone:414-841-8902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY63 018156225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist