Provider Demographics
NPI:1003239682
Name:DWYRE, EILEEN (MA OTR/L)
Entity type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:
Last Name:DWYRE
Suffix:
Gender:F
Credentials:MA OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BRIDGES ST
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-3559
Mailing Address - Country:US
Mailing Address - Phone:973-234-7070
Mailing Address - Fax:
Practice Address - Street 1:38 W 32ND ST
Practice Address - Street 2:602
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-3816
Practice Address - Country:US
Practice Address - Phone:212-290-0292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-02
Last Update Date:2014-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005969-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics