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NPI 1548046238

NPI 1548046238 : DABAN LIM : QUEENS, NY

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General NPI Number Information
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    NPI Number           |    1548046238
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    Entity Type          |    Individual 
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    Provider Name        |    DABAN LIM
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/07/2023
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    Last Update Date     |    09/07/2023
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Provider Practice Location Address
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    Address Line         |    107-02R JAMAICA AVE RICHMOND HILL
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    City                 |    QUEENS
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    State                |    NY
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    Zip                  |    11418
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    Country              |    US
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    Telephone            |    347-829-3890
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    318A ROFF AVE 
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    City                 |    PALISADES PARK
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    State                |    NJ
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    Zip                  |    07650-6707
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    225X00000X
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    Taxonomy Name        |    Occupational Therapist
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    License Number       |    028106
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    License Number State |    NY
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