Provider Demographics
NPI:1164670527
Name:DIMASI, KRISTINE M (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINE
Middle Name:M
Last Name:DIMASI
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 1:308 PRAIRIE CT
Mailing Address - Street 2:
Mailing Address - City:MANORVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11949-2653
Mailing Address - Country:US
Mailing Address - Phone:631-875-4887
Mailing Address - Fax:
Practice Address - Street 1:41 CEDAR LANE
Practice Address - Street 2:
Practice Address - City:REMSENBURG
Practice Address - State:NY
Practice Address - Zip Code:11960-1025
Practice Address - Country:US
Practice Address - Phone:631-325-6963
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011786225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics