MEDICARE: LUZ DENIA CONTRERAS

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	225X00000X	Occupational Therapist	009761-1	NY

General Provider Information

NPI Number	:	1841508959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUZ DENIA CONTRERAS

Provider Business Mailing Address
First Line	:	8340 AUSTIN ST
Second Line	:	5R
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-1833
Country	:	US
Telephone Number	:	917-379-9706
Fax Number	:	718-674-6472

Provider Business Practice Location Address
First Line	:	8340 AUSTIN ST
Second Line	:	5R
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-1833
Country	:	US
Telephone Number	:	917-379-9706
Fax Number	:	718-674-6472

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

Provider Enumeration Date	:	09/23/2010
Last Update Date	:	09/23/2010

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Directions to “ LUZ DENIA CONTRERAS ” Practice Location

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