Provider Demographics
NPI:1386277960
Name:NAYBERG, RHONDA ELLEN (MS, BA, OTR)
Entity type:Individual
Prefix:MRS
First Name:RHONDA
Middle Name:ELLEN
Last Name:NAYBERG
Suffix:
Gender:F
Credentials:MS, BA, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MONTEFIORE MEDICAL CENTER
Mailing Address - Street 2:111 E 210 STREET
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467
Mailing Address - Country:US
Mailing Address - Phone:718-920-6365
Mailing Address - Fax:718-920-2289
Practice Address - Street 1:MONTEFIORE MEDICAL CENTER OCCUPATIONAL THERAPY DEPT
Practice Address - Street 2:111 E 210 STREET GROUND FLOOR BLUE ZONE
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-6365
Practice Address - Fax:718-920-2289
Is Sole Proprietor?:No
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004440225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist