Provider Demographics
NPI:1770048498
Name:STEVENS, TAYLOR (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:STEVENS
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:TAYLOR
Other - Middle Name:
Other - Last Name:PANZARINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:691 SWINDON ROW
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-1432
Mailing Address - Country:US
Mailing Address - Phone:631-278-9523
Mailing Address - Fax:
Practice Address - Street 1:129 LAKELAND AVE
Practice Address - Street 2:
Practice Address - City:SAYVILLE
Practice Address - State:NY
Practice Address - Zip Code:11782-1992
Practice Address - Country:US
Practice Address - Phone:631-563-1160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020898-1225XP0019X
225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation