Provider Demographics
NPI:1215231154
Name:BRETT, DANA CARYN (OTR)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:CARYN
Last Name:BRETT
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 1:11115 75TH AVE APT 3E
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-6375
Mailing Address - Country:US
Mailing Address - Phone:646-284-6444
Mailing Address - Fax:
Practice Address - Street 1:11115 75TH AVE APT 3E
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-6375
Practice Address - Country:US
Practice Address - Phone:646-284-6444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-07
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011412-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist