Healthcare Provider Details

I. General information

NPI: 1568607067
Provider Name (Legal Business Name): KEREN K TOBON OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KEREN K ABREU OTR/L

II. Dates (important events)

Enumeration Date: 12/11/2008
Last Update Date: 03/27/2023
Certification Date: 06/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 HAMILTON ST
DOBBS FERRY NY
10522-2848
US

IV. Provider business mailing address

40 VILLAGE GRN UNIT 397
BEDFORD NY
10506-7018
US

V. Phone/Fax

Practice location:
  • Phone: 914-306-0863
  • Fax:
Mailing address:
  • Phone: 914-306-0863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number014184-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: