Provider Demographics
NPI:1780472753
Name:RAMESHAN, ANASWARA (OTR/L)
Entity type:Individual
Prefix:
First Name:ANASWARA
Middle Name:
Last Name:RAMESHAN
Suffix:
Gender:
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001-1300
Mailing Address - Country:US
Mailing Address - Phone:516-413-4619
Mailing Address - Fax:
Practice Address - Street 1:210 CHERRY LN
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001-1300
Practice Address - Country:US
Practice Address - Phone:516-413-4619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030048225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist