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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MIRA GOLDIS WACHSTOCK, MA, OTR/L

Active Sole Proprietor

MIRA GOLDIS WACHSTOCK, MA, OTR/L is a Pediatric Occupational Therapist healthcare provider located in HOLLIS, New York. NPI 1881834810 is currently active in the NPPES registry. Verify at CMS.

Pediatric Occupational Therapist · HOLLIS, NY

Registration Details

NPI Number
1881834810
Provider Type
Individual
Gender
Female
NPI Issued
Mar 4, 2009 (17.408367490311 yrs)
Last Updated
Mar 4, 2009
License
010633-1 (NY)
Sole Proprietor
Yes

Practice Information

Address
19614 POMPEII AVE
HOLLIS, NY, 114231418
Browse NY providers · Browse ZIP 11423
Phone
7184640709
Primary Specialty
Pediatric Occupational Therapist
225XP0200X

Other Pediatric Occupational Therapist Providers in HOLLIS, NY

Name Credential NPI
KENNETH WACHSTOCK MA, OTR/L 1295976231
RUTH SALHOLZ MEYERS OTR/L 1811254642
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.