Provider Demographics
NPI:1154963510
Name:CALLENDER, TRICIA ANN PAULA (OTR/L)
Entity type:Individual
Prefix:MS
First Name:TRICIA
Middle Name:ANN PAULA
Last Name:CALLENDER
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 1:2545 SEDGWICK AVE APT 7B
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10468-3808
Mailing Address - Country:US
Mailing Address - Phone:917-991-8286
Mailing Address - Fax:
Practice Address - Street 1:2545 SEDGWICK AVE APT 7B
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468-3808
Practice Address - Country:US
Practice Address - Phone:917-991-8286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024128225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist