Provider Demographics
NPI:1043521040
Name:PUTTERMAN, MELISSA ERIN
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ERIN
Last Name:PUTTERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 E 63RD ST
Mailing Address - Street 2:APT 32C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7466
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:207 E 84TH ST
Practice Address - Street 2:ROOM 205
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-2972
Practice Address - Country:US
Practice Address - Phone:212-517-2777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY16166225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics