Provider Demographics
NPI:1295260727
Name:BENNETT, ANDREA ESTHER (OTD, OTR)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:ESTHER
Last Name:BENNETT
Suffix:
Gender:F
Credentials:OTD, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 BENNETT AVE
Mailing Address - Street 2:APT 65
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-3628
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21 BENNETT AVE
Practice Address - Street 2:APT 65
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-3628
Practice Address - Country:US
Practice Address - Phone:305-609-0257
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-21
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist