Theresa Shanley Prosek, MS, OTR/L

NPI #1720559909 in Bayport, New York

Provider Information

NPI Number: 1720559909
Entity Type: Individual
Name: Theresa Shanley Prosek, MS, OTR/L
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Occupational Therapist
Credential: MS, OTR/L
Enumeration Date: Dec 16, 2018
Last Updated: Dec 5, 2019

Practice Location

Address: 454 SYLVAN AVE
City: Bayport
State: New York
ZIP Code: 11705
Phone: (631) 383-2375

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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