Provider Demographics
NPI:1174669196
Name:D'AMORE, DANA LYNN (OTR)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:LYNN
Last Name:D'AMORE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1281 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902-3544
Mailing Address - Country:US
Mailing Address - Phone:203-210-2840
Mailing Address - Fax:203-210-2841
Practice Address - Street 1:10753 FALLS RD PAVILLION II
Practice Address - Street 2:#235
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21093
Practice Address - Country:US
Practice Address - Phone:410-583-2665
Practice Address - Fax:410-847-3838
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2017-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004100225X00000X
MD05260225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist