Provider Demographics
NPI:1831294248
Name:OSTER, STACY M (OCCUPATIONAL THERAPI)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:M
Last Name:OSTER
Suffix:
Gender:F
Credentials:OCCUPATIONAL THERAPI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 CROSSWAYS PARK DR W
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-2037
Mailing Address - Country:US
Mailing Address - Phone:516-536-2800
Mailing Address - Fax:516-992-4637
Practice Address - Street 1:45 CROSSWAYS PARK DR W
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-2037
Practice Address - Country:US
Practice Address - Phone:516-536-2800
Practice Address - Fax:516-992-4637
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY13914-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQU2091Medicare PIN