Provider Demographics
NPI:1154678530
Name:BORECKI, YVETTE MEDICI (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:MEDICI
Last Name:BORECKI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 FITCH AVE
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-5338
Mailing Address - Country:US
Mailing Address - Phone:203-662-0520
Mailing Address - Fax:203-662-1232
Practice Address - Street 1:62 FITCH AVE
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-5338
Practice Address - Country:US
Practice Address - Phone:203-662-0520
Practice Address - Fax:203-662-1232
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-05
Last Update Date:2012-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001844-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics