Provider Demographics
NPI:1699870592
Name:BURKHARDT, ANN (OTD, OTR/L, FAOTA)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:
Last Name:BURKHARDT
Suffix:
Gender:F
Credentials:OTD, OTR/L, FAOTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E 91ST ST APT 4B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-2458
Mailing Address - Country:US
Mailing Address - Phone:718-780-4332
Mailing Address - Fax:212-423-0587
Practice Address - Street 1:160 E 91ST ST APT 4B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-2458
Practice Address - Country:US
Practice Address - Phone:718-780-4332
Practice Address - Fax:212-423-0587
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002131-1225X00000X
RIOT00177225X00000X
MA3314225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist