Basic Information
Provider Information
NPI: 1366753212
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ASPIOTIS
FirstName: ANTONIA
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: M.S., OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 14 RANDOLPH PL
Address2:  
City: TRUMBULL
State: CT
PostalCode: 066112924
CountryCode: US
TelephoneNumber: 7189981415
FaxNumber:  
Practice Location
Address1: 1651 CONEY ISLAND AVE
Address2:  
City: BROOKLYN
State: NY
PostalCode: 112305849
CountryCode: US
TelephoneNumber: 7189981415
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/25/2010
LastUpdateDate: 06/25/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X013498NYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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