Provider Demographics
NPI:1720351398
Name:ANHALT, AMY (OTR)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:ANHALT
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 1:315 E 86TH ST APT 6KE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-4740
Mailing Address - Country:US
Mailing Address - Phone:917-627-2744
Mailing Address - Fax:
Practice Address - Street 1:315 E 86TH ST APT 6KE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-4740
Practice Address - Country:US
Practice Address - Phone:917-627-2744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006782-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics