Provider Demographics
NPI:1902280209
Name:NASUTI, CRYSTAL NICOLE (MS OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:NICOLE
Last Name:NASUTI
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:MS
Other - First Name:CRYSTAL
Other - Middle Name:NICOLE
Other - Last Name:TROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS OTR/L
Mailing Address - Street 1:2868 BELTAGH AVENUE
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710
Mailing Address - Country:US
Mailing Address - Phone:631-572-6919
Mailing Address - Fax:516-809-5645
Practice Address - Street 1:2868 BELTAGH AVENUE
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710
Practice Address - Country:US
Practice Address - Phone:631-572-6919
Practice Address - Fax:516-809-5645
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-16
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0198141225X00000X
NY019814-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist