Provider Demographics
NPI:1427526391
Name:HARILALL, ANIL JEREMY (OTR/L)
Entity type:Individual
Prefix:MR
First Name:ANIL
Middle Name:JEREMY
Last Name:HARILALL
Suffix:
Gender:M
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 1:144 OAKLAND ST
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06615-5626
Mailing Address - Country:US
Mailing Address - Phone:646-961-9071
Mailing Address - Fax:
Practice Address - Street 1:70 PARSONAGE RD
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-3996
Practice Address - Country:US
Practice Address - Phone:203-618-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-08
Last Update Date:2018-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5027225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist