Provider Demographics
NPI:1902224090
Name:BERLIN, REBECCA ERIN (OTR/L)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ERIN
Last Name:BERLIN
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 1:10326 68TH RD
Mailing Address - Street 2:APT. A31
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3200
Mailing Address - Country:US
Mailing Address - Phone:201-390-3192
Mailing Address - Fax:
Practice Address - Street 1:10326 68TH RD
Practice Address - Street 2:APT. A31
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3200
Practice Address - Country:US
Practice Address - Phone:201-390-3192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-04
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018731225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist