Provider Demographics
NPI:1235242579
Name:WHITMAN, DOUGLAS J (OTR/L, ATP)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:J
Last Name:WHITMAN
Suffix:
Gender:M
Credentials:OTR/L, ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 W 181ST ST
Mailing Address - Street 2:SUITE 332
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-4516
Mailing Address - Country:US
Mailing Address - Phone:917-449-5270
Mailing Address - Fax:
Practice Address - Street 1:408 E 137TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10454-4004
Practice Address - Country:US
Practice Address - Phone:718-993-3458
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007135-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist