Provider Demographics
NPI:1184877581
Name:CARDONE, CRYSTAL MARIE (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:MARIE
Last Name:CARDONE
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:MARIE
Other - Last Name:GREBELDINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA
Mailing Address - Street 1:400 HOWELL ST
Mailing Address - Street 2:
Mailing Address - City:PINE BUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12566-6505
Mailing Address - Country:US
Mailing Address - Phone:845-649-3510
Mailing Address - Fax:
Practice Address - Street 1:40 PARK LN
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:NY
Practice Address - Zip Code:12528-2824
Practice Address - Country:US
Practice Address - Phone:845-883-5151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-29
Last Update Date:2012-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017476225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist