Provider Demographics
NPI:1225370174
Name:DECHIARO, DANA JEAN (MS, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:JEAN
Last Name:DECHIARO
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-3134
Mailing Address - Country:US
Mailing Address - Phone:908-418-1142
Mailing Address - Fax:
Practice Address - Street 1:110 E 107TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-3904
Practice Address - Country:US
Practice Address - Phone:212-860-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-19
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017929225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist