Healthcare Provider Details

I. General information

NPI: 1285910091
Provider Name (Legal Business Name): DEBORAH FROMM OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2011
Last Update Date: 10/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 W END AVE SUITE 1M
NEW YORK NY
10023-4902
US

IV. Provider business mailing address

817 MOORE ST
WOODMERE NY
11598-2315
US

V. Phone/Fax

Practice location:
  • Phone: 212-600-4781
  • Fax:
Mailing address:
  • Phone: 516-384-7888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number016987
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: