Provider Demographics
NPI:1134373608
Name:STAVSKY, MIRIAM (MS OTR/L)
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:
Last Name:STAVSKY
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:MIRIAM
Other - Middle Name:
Other - Last Name:ADLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:490 W 187TH ST APT 5F
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-1539
Mailing Address - Country:US
Mailing Address - Phone:201-906-6874
Mailing Address - Fax:
Practice Address - Street 1:490 W 187TH ST APT 5F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-1539
Practice Address - Country:US
Practice Address - Phone:201-906-6874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014145225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist