Provider Demographics
NPI:1881905024
Name:REICH, MIRIAM (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:MIRIAM
Middle Name:
Last Name:REICH
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 1:1500 OCEAN PKWY
Mailing Address - Street 2:APT 4F
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-6456
Mailing Address - Country:US
Mailing Address - Phone:718-998-2959
Mailing Address - Fax:
Practice Address - Street 1:1500 OCEAN PKWY
Practice Address - Street 2:APT 4F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-6456
Practice Address - Country:US
Practice Address - Phone:718-998-2959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-22
Last Update Date:2010-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014942225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist