Provider Demographics
NPI:1265740831
Name:SENERIZ, BLANCA (OTR)
Entity type:Individual
Prefix:
First Name:BLANCA
Middle Name:
Last Name:SENERIZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9522 63RD RD
Mailing Address - Street 2:403
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1142
Mailing Address - Country:US
Mailing Address - Phone:718-897-1260
Mailing Address - Fax:
Practice Address - Street 1:9522 63RD RD
Practice Address - Street 2:403
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1142
Practice Address - Country:US
Practice Address - Phone:718-897-1260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003491225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist