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Contact Information

STEPHEN G EDAKULAM, OTR/L
12 HIGHLAND BLVD
LYNBROOK, NY11563
 Phone: 516-554-7377
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapist

225X00000X 67 Occupational Therapist in Private Practice
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for STEPHEN G EDAKULAM · (Male)

NPI Number 1386992139
Status Active
Credentials OTR/L (Occupational Therapist, Registered, Licensed)
Entity Individual
Enumeration date 08/28/2012
Last updated 08/28/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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