Provider Demographics
NPI:1023321049
Name:BROWN-WASSINGER, CAROL (MS, OTR/L)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:
Last Name:BROWN-WASSINGER
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 1:12406 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356-1802
Mailing Address - Country:US
Mailing Address - Phone:718-352-0104
Mailing Address - Fax:718-352-0131
Practice Address - Street 1:12406 14TH AVE
Practice Address - Street 2:
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-1802
Practice Address - Country:US
Practice Address - Phone:718-352-0104
Practice Address - Fax:718-352-0131
Is Sole Proprietor?:No
Enumeration Date:2010-07-19
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015478-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics