Provider Demographics
NPI:1124418512
Name:MEJIA, DULBANIA (COTA)
Entity Type:Individual
Prefix:
First Name:DULBANIA
Middle Name:
Last Name:MEJIA
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 WARNER AVE
Mailing Address - Street 2:REHABILITATION DEPARTMENT
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1000
Mailing Address - Country:US
Mailing Address - Phone:516-621-5400
Mailing Address - Fax:
Practice Address - Street 1:255 WARNER AVE
Practice Address - Street 2:REHABILITATION DEPARTMENT
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-1000
Practice Address - Country:US
Practice Address - Phone:516-621-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-23
Last Update Date:2015-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant