Provider Demographics
NPI:1376825539
Name:STEWART, KIMBERLY PIRO (MS OTR/L)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:PIRO
Last Name:STEWART
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 STABLE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:CT
Mailing Address - Zip Code:06468-1960
Mailing Address - Country:US
Mailing Address - Phone:203-273-2211
Mailing Address - Fax:
Practice Address - Street 1:2505 BLACK ROCK TPKE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-2408
Practice Address - Country:US
Practice Address - Phone:203-273-2211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003716225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics