Provider Demographics
NPI:1528326501
Name:GHELMAN, SANDRA (OTR/L)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:GHELMAN
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 1:25 JAY ST
Mailing Address - Street 2:APT 13
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-3094
Mailing Address - Country:US
Mailing Address - Phone:516-303-6432
Mailing Address - Fax:
Practice Address - Street 1:25 JAY ST
Practice Address - Street 2:APT 13
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-3094
Practice Address - Country:US
Practice Address - Phone:516-303-6432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-27
Last Update Date:2013-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017279-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist