Provider Demographics
NPI:1982422242
Name:FLIEGELMAN, REBECCA (OTR/L)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:FLIEGELMAN
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 1:13 OLD POMONA RD
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-1736
Mailing Address - Country:US
Mailing Address - Phone:845-304-3140
Mailing Address - Fax:
Practice Address - Street 1:13 OLD POMONA RD
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-1736
Practice Address - Country:US
Practice Address - Phone:845-304-3140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029513225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist