Provider Demographics
NPI:1902325566
Name:HEITNER, ANDREW (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:HEITNER
Suffix:
Gender:M
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 FOXRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-7802
Mailing Address - Country:US
Mailing Address - Phone:631-786-8352
Mailing Address - Fax:
Practice Address - Street 1:4 FOXRIDGE CIR
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-7802
Practice Address - Country:US
Practice Address - Phone:631-786-8352
Practice Address - Fax:631-786-8352
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-14
Last Update Date:2017-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist