Provider Demographics
NPI:1922419035
Name:HALUDA, MALGORZATA (OTR/L)
Entity Type:Individual
Prefix:
First Name:MALGORZATA
Middle Name:
Last Name:HALUDA
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 1:51 SPAR DR
Mailing Address - Street 2:
Mailing Address - City:MASTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11951-2005
Mailing Address - Country:US
Mailing Address - Phone:631-605-1327
Mailing Address - Fax:
Practice Address - Street 1:51 SPAR DR
Practice Address - Street 2:
Practice Address - City:MASTIC BEACH
Practice Address - State:NY
Practice Address - Zip Code:11951-2005
Practice Address - Country:US
Practice Address - Phone:631-605-1327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018824225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist