Provider Demographics
NPI:1295781524
Name:SATAWA, JEAN M (OTR)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:M
Last Name:SATAWA
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 1:855 MULBERRY RD
Mailing Address - Street 2:
Mailing Address - City:VALLEY COTTAGE
Mailing Address - State:NY
Mailing Address - Zip Code:10989-2325
Mailing Address - Country:US
Mailing Address - Phone:845-268-6831
Mailing Address - Fax:
Practice Address - Street 1:7 RESERVOIR RD
Practice Address - Street 2:
Practice Address - City:N WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-2522
Practice Address - Country:US
Practice Address - Phone:914-948-7190
Practice Address - Fax:914-948-7491
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005760225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ29031Medicare ID - Type Unspecified