Provider Demographics
NPI:1447540174
Name:TRINIDAD, OLIVER (OT)
Entity type:Individual
Prefix:
First Name:OLIVER
Middle Name:
Last Name:TRINIDAD
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-4608
Mailing Address - Country:US
Mailing Address - Phone:718-239-8239
Mailing Address - Fax:212-208-4689
Practice Address - Street 1:50 PARKVIEW DR
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-4608
Practice Address - Country:US
Practice Address - Phone:718-239-8239
Practice Address - Fax:212-208-4689
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009171225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist