Provider Demographics
NPI:1205081817
Name:VAYDA, SHARI ELLEN (MA, OTR/L)
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:ELLEN
Last Name:VAYDA
Suffix:
Gender:F
Credentials:MA, OTR/L
Other - Prefix:
Other - First Name:SHARI
Other - Middle Name:ELLEN
Other - Last Name:ROUDER-VAYDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, OTR/L
Mailing Address - Street 1:39 W 14TH ST STE 307
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-7405
Mailing Address - Country:US
Mailing Address - Phone:646-325-8463
Mailing Address - Fax:212-414-2777
Practice Address - Street 1:39 W 14TH ST STE 307
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7405
Practice Address - Country:US
Practice Address - Phone:646-325-8463
Practice Address - Fax:212-414-2777
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008334-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist