Healthcare Provider Details

I. General information

NPI: 1740832435
Provider Name (Legal Business Name): DEENA KLAVAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2019
Last Update Date: 07/12/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 S 5TH AVE
HIGHLAND PARK NJ
08904-2604
US

IV. Provider business mailing address

305 HARRISON AVE
HIGHLAND PARK NJ
08904-1839
US

V. Phone/Fax

Practice location:
  • Phone: 732-813-4263
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: