Provider Demographics
NPI:1023154044
Name:HAIMER, SHARON DAITCH (OTR)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:DAITCH
Last Name:HAIMER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:DAITCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:1856A CORPORAL KENNEDY ST
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-1447
Mailing Address - Country:US
Mailing Address - Phone:718-631-9575
Mailing Address - Fax:
Practice Address - Street 1:1500 PELHAM PKWY S
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1100
Practice Address - Country:US
Practice Address - Phone:212-780-2762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2015-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002419225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist