Provider Demographics
NPI:1952676173
Name:HILLELSOHN, MIRIAM JUDITH (OTR/L)
Entity Type:Individual
Prefix:
First Name:MIRIAM
Middle Name:JUDITH
Last Name:HILLELSOHN
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 1:1827 ARCHER ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-6203
Mailing Address - Country:US
Mailing Address - Phone:718-931-4274
Mailing Address - Fax:
Practice Address - Street 1:1827 ARCHER ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-6203
Practice Address - Country:US
Practice Address - Phone:718-931-4274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics