Provider Demographics
NPI:1831347004
Name:ZENNER-RUBESH, CYNTHIA C (OTR/L)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:C
Last Name:ZENNER-RUBESH
Suffix:
Gender:F
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 1:46 HALLOCK AVE
Mailing Address - Street 2:
Mailing Address - City:SMITHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11787-3836
Mailing Address - Country:US
Mailing Address - Phone:631-979-4412
Mailing Address - Fax:631-656-8489
Practice Address - Street 1:46 HALLOCK AVE
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-3836
Practice Address - Country:US
Practice Address - Phone:631-979-4412
Practice Address - Fax:631-656-8489
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-30
Last Update Date:2008-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005573-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist