MEDICARE: DENESE CARTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0019X	Physical Rehabilitation Occupational Therapist
2	225XN1300X	Neurorehabilitation Occupational Therapist
3	225XF0002X	Feeding, Eating & Swallowing Occupational Therapist
4	225XE1200X	Ergonomics Occupational Therapist
5	225XH1200X	Hand Occupational Therapist
6	225XP0200X	Pediatric Occupational Therapist	008746-01	NY

General Provider Information

NPI Number	:	1326291493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENESE CARTER

Provider Business Mailing Address
First Line	:	49 MOLYNEAUX RD
Second Line	:
City	:	VALLEY STREAM
State	:	NY
Zip	:	11580-1925
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	49 MOLYNEAUX RD
Second Line	:
City	:	VALLEY STREAM
State	:	NY
Zip	:	11580-1925
Country	:	US
Telephone Number	:	347-228-5228
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2008
Last Update Date	:	11/03/2008

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