Provider Demographics
NPI:1164720611
Name:DUBIN, ADINA (OTR/L)
Entity Type:Individual
Prefix:
First Name:ADINA
Middle Name:
Last Name:DUBIN
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 1:36-02 HILLSIDE TER
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-4235
Mailing Address - Country:US
Mailing Address - Phone:551-206-6829
Mailing Address - Fax:
Practice Address - Street 1:36-02 HILLSIDE TER
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-4235
Practice Address - Country:US
Practice Address - Phone:551-206-6829
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016637225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist