MEDICARE: MS. PRIYA DARSHANI DEONARAIN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225XP0200X	Pediatric Occupational Therapist	014124-1	NY

General Provider Information

NPI Number	:	1699919621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. PRIYA DARSHANI DEONARAIN

Provider Business Mailing Address
First Line	:	116-12 150TH AVENUE
Second Line	:	SOUTH OZONE PARK
City	:	JAMAICA
State	:	NY
Zip	:	11420
Country	:	US
Telephone Number	:	646-309-4942
Fax Number	:

Provider Business Practice Location Address
First Line	:	11612 150TH AVE
Second Line	:	SOUTH OZONE PARK
City	:	JAMAICA
State	:	NY
Zip	:	11420-3911
Country	:	US
Telephone Number	:	646-309-4942
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2009
Last Update Date	:	08/31/2010

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