Provider Demographics
NPI:1174249247
Name:KRESMERY, ERIN (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:KRESMERY
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 1:321 HAMILTON AVE # D
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3586
Mailing Address - Country:US
Mailing Address - Phone:203-554-8911
Mailing Address - Fax:
Practice Address - Street 1:396 DANBURY RD
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-2024
Practice Address - Country:US
Practice Address - Phone:203-202-7654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT005955225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT005955OtherNATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY