Healthcare Provider Details
I. General information
NPI: 1447528625
Provider Name (Legal Business Name): DALU OCCUPATIONAL THERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/02/2011
Last Update Date: 12/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9 NORTHERN PKWY E
PLAINVIEW NY
11803-2007
US
IV. Provider business mailing address
9 NORTHERN PKWY E
PLAINVIEW NY
11803-2007
US
V. Phone/Fax
- Phone: 516-333-3642
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 252Y00000X |
| Taxonomy | Early Intervention Provider Agency |
| License Number | 011398-1 |
| License Number State | NY |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: MRS.
DARA
J
DONEWITZ
Title or Position: CEO
Credential: MA, OTR/L
Phone: 516-333-3642