Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ambryel Marie Moder

Individual provider Occupational Therapist · NPI 1124546155

Ambryel Marie Moder is an Occupational Therapist in Middle Island, New York. Practices as a sole proprietor and works from 2 locations. Licensed in New York.

Licensed in
NY
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

35 Longwood Rd
Middle Island, NY 11953-2045
Phone: (631) 924-0008
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 300 Garden City Plz Ste 350, Garden City, NY 11530-3358 — (516) 531-7210

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 022276 (NY)
Occupational Therapist Taxonomy 225X00000X · Licence P07796 (NY)

Record details

NPI number1124546155
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 30, 2017
Last updated in NPPESMarch 17, 2018

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