Provider Demographics
NPI:1841449519
Name:OLMSTEAD, SUSAN J (OTR/L)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:J
Last Name:OLMSTEAD
Suffix:
Gender:F
Credentials:OTR/L
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:82-30 138TH STREET
Mailing Address - Street 2:APARTMENT 1M
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-1483
Mailing Address - Country:US
Mailing Address - Phone:516-641-3262
Mailing Address - Fax:
Practice Address - Street 1:8230 138TH ST
Practice Address - Street 2:APARTMENT 1M
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-1481
Practice Address - Country:US
Practice Address - Phone:516-641-3262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006861-1225XN1300X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation