Provider Demographics
NPI:1194947184
Name:CAWLEY, SHIRLEY ROMERO
Entity type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:ROMERO
Last Name:CAWLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SHIRLEY
Other - Middle Name:
Other - Last Name:CAWLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OTRL
Mailing Address - Street 1:98 S FRANKLIN AVE APT 20
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-6118
Mailing Address - Country:US
Mailing Address - Phone:718-291-3888
Mailing Address - Fax:
Practice Address - Street 1:14916 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-4038
Practice Address - Country:US
Practice Address - Phone:718-291-3888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY033880843Medicaid