Provider Demographics
NPI:1790461119
Name:GIARRAPUTO, AMBER NICOLE (MSOT)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:NICOLE
Last Name:GIARRAPUTO
Suffix:
Gender:F
Credentials:MSOT
Other - Prefix:MISS
Other - First Name:AMBER
Other - Middle Name:NICOLE
Other - Last Name:WALTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSOT
Mailing Address - Street 1:1 COLBY DR
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-5104
Mailing Address - Country:US
Mailing Address - Phone:631-560-0766
Mailing Address - Fax:
Practice Address - Street 1:6112 JERICHO TPKE
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-2838
Practice Address - Country:US
Practice Address - Phone:631-486-6060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026368225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist