Provider Demographics
NPI:1588939326
Name:LIBMAN, ATARA (MS, OTR/L)
Entity type:Individual
Prefix:MS
First Name:ATARA
Middle Name:
Last Name:LIBMAN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:680 W 246TH ST
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-3520
Mailing Address - Country:US
Mailing Address - Phone:917-297-3574
Mailing Address - Fax:
Practice Address - Street 1:680 W 246TH ST
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-3520
Practice Address - Country:US
Practice Address - Phone:917-297-3574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011830225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics