Provider Demographics
NPI:1023892064
Name:OVIEDO, VERONICA (OTR/L)
Entity type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:OVIEDO
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 1:122 ELM ST
Mailing Address - Street 2:
Mailing Address - City:CALVERTON
Mailing Address - State:NY
Mailing Address - Zip Code:11933-9784
Mailing Address - Country:US
Mailing Address - Phone:631-875-1127
Mailing Address - Fax:
Practice Address - Street 1:122 ELM ST
Practice Address - Street 2:
Practice Address - City:CALVERTON
Practice Address - State:NY
Practice Address - Zip Code:11933-9784
Practice Address - Country:US
Practice Address - Phone:631-875-1127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027316225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty