Provider Demographics
NPI:1801022785
Name:OGIR, CRYSTAL (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:CRYSTAL
Middle Name:
Last Name:OGIR
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 1:30 EVERETT ST
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-3231
Mailing Address - Country:US
Mailing Address - Phone:917-515-4724
Mailing Address - Fax:
Practice Address - Street 1:30 EVERETT ST
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-3231
Practice Address - Country:US
Practice Address - Phone:917-515-4724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-04
Last Update Date:2009-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY08149-1172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker