Provider Demographics
NPI:1740950138
Name:TREFETHEN, CLAIRE RUTH (OTD)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:RUTH
Last Name:TREFETHEN
Suffix:
Gender:
Credentials:OTD
Other - Prefix:
Other - First Name:CLAIRE
Other - Middle Name:KATHERINE
Other - Last Name:RUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD
Mailing Address - Street 1:102 MADISON AVE FL 8
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-7584
Mailing Address - Country:US
Mailing Address - Phone:212-759-2282
Mailing Address - Fax:212-379-2123
Practice Address - Street 1:41 CLARK ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-2415
Practice Address - Country:US
Practice Address - Phone:646-518-5566
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-16
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZOTH-008610225X00000X
NY027577225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist