Provider Demographics
NPI:1487808168
Name:NADAL, MICHELLE (OTR)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:NADAL
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 DREW LN
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-3751
Mailing Address - Country:US
Mailing Address - Phone:347-526-3645
Mailing Address - Fax:
Practice Address - Street 1:610 DREW LN
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-3751
Practice Address - Country:US
Practice Address - Phone:347-526-3645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-08
Last Update Date:2008-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010466225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics