Provider Demographics
NPI:1811207376
Name:GREENSPAN, SARAH (OTR/L)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GREENSPAN
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 1:117 COLONY CIR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1403
Mailing Address - Country:US
Mailing Address - Phone:732-370-6810
Mailing Address - Fax:
Practice Address - Street 1:117 COLONY CIR
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1403
Practice Address - Country:US
Practice Address - Phone:732-370-6810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014028225X00000X
NJ46TR00415700225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist