Provider Demographics
NPI:1932491909
Name:STULBERGER, TAMAR RENA (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:TAMAR
Middle Name:RENA
Last Name:STULBERGER
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 1:281 SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-2409
Mailing Address - Country:US
Mailing Address - Phone:516-821-0003
Mailing Address - Fax:
Practice Address - Street 1:100 GLEN COVE AVE
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2818
Practice Address - Country:US
Practice Address - Phone:516-609-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014838225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist