Provider Demographics
NPI:1699145235
Name:MALINSKA, AGNIESZKA (OTR/L)
Entity type:Individual
Prefix:
First Name:AGNIESZKA
Middle Name:
Last Name:MALINSKA
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 1:104 CANOPUS HOLLOW RD
Mailing Address - Street 2:
Mailing Address - City:PUTNAM VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10579-1803
Mailing Address - Country:US
Mailing Address - Phone:845-284-2048
Mailing Address - Fax:
Practice Address - Street 1:104 CANOPUS HOLLOW RD
Practice Address - Street 2:
Practice Address - City:PUTNAM VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10579-1803
Practice Address - Country:US
Practice Address - Phone:845-284-2048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-25
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019899225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist