Provider Demographics
NPI:1790340461
Name:OSHEROVITZ, CHERYL ANNE (OTR/L)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANNE
Last Name:OSHEROVITZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CAROLL DR
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-3002
Mailing Address - Country:US
Mailing Address - Phone:845-664-3906
Mailing Address - Fax:
Practice Address - Street 1:450 MAMARONECK AVE STE 412
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-2430
Practice Address - Country:US
Practice Address - Phone:914-686-3116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-07
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023504225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist