Healthcare Provider Details

I. General information

NPI: 1649574724
Provider Name (Legal Business Name): HARRY DUFFY OTL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2011
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

670 STONELEIGH AVE
CARMEL NY
10512-3997
US

IV. Provider business mailing address

22 LLOYD AVE
NEW FAIRFIELD CT
06812-4420
US

V. Phone/Fax

Practice location:
  • Phone: 845-279-1785
  • Fax:
Mailing address:
  • Phone: 203-207-1280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number006264-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number006264-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: