Provider Demographics
NPI:1972046134
Name:ESTERKIS, MIRIAM (OTR)
Entity Type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:
Last Name:ESTERKIS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 W 3RD ST
Mailing Address - Street 2:APT 2412
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1782
Mailing Address - Country:US
Mailing Address - Phone:908-500-6135
Mailing Address - Fax:
Practice Address - Street 1:28 W 3RD ST
Practice Address - Street 2:APT 2412
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-1782
Practice Address - Country:US
Practice Address - Phone:908-500-6135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000538-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist