Provider Demographics
NPI:1437285160
Name:DEBLER SEIDEL, KRISTA (OTRL)
Entity type:Individual
Prefix:
First Name:KRISTA
Middle Name:
Last Name:DEBLER SEIDEL
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 UNION AVE
Mailing Address - Street 2:
Mailing Address - City:CENTER MORICHES
Mailing Address - State:NY
Mailing Address - Zip Code:11934-3213
Mailing Address - Country:US
Mailing Address - Phone:631-375-5313
Mailing Address - Fax:631-878-0795
Practice Address - Street 1:130 F MONTAUK HWY
Practice Address - Street 2:
Practice Address - City:EAST MORICHES
Practice Address - State:NY
Practice Address - Zip Code:11940
Practice Address - Country:US
Practice Address - Phone:631-874-0571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007249-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist