Provider Demographics
NPI:1720314321
Name:BEGENT, KRISTINA MARIE (OTR)
Entity type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:MARIE
Last Name:BEGENT
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:KRISTINA
Other - Middle Name:MARIE
Other - Last Name:OLIVEIRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 ROBINSON AVE
Mailing Address - Street 2:
Mailing Address - City:EAST PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-4841
Mailing Address - Country:US
Mailing Address - Phone:631-742-5472
Mailing Address - Fax:
Practice Address - Street 1:122 W ROE BLVD
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-2569
Practice Address - Country:US
Practice Address - Phone:631-742-5472
Practice Address - Fax:631-627-8533
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics