Basic Information
Provider Information
NPI: 1134255177
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZEFERINO
FirstName: SARA
MiddleName: IVEY
NamePrefix: MISS
NameSuffix:  
Credential: OTR/L
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1377 MOTOR PKWY STE 307
Address2:  
City: ISLANDIA
State: NY
PostalCode: 117495258
CountryCode: US
TelephoneNumber: 6315805200
FaxNumber: 6317608306
Practice Location
Address1: 108 BILBY RD STE 201
Address2:  
City: HACKETTSTOWN
State: NJ
PostalCode: 078404174
CountryCode: US
TelephoneNumber: 9086845646
FaxNumber: 9086845649
Other Information
ProviderEnumerationDate: 02/26/2007
LastUpdateDate: 06/30/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 06/30/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000XOT 16743FLN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 
225X00000XOT004105GAN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 
225X00000X46TR00928200NJY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

No ID Information.


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