Provider Demographics
NPI:1265687131
Name:DUBIN, STEVEN LEONARD (MA OTR/L)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:LEONARD
Last Name:DUBIN
Suffix:
Gender:M
Credentials:MA OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 AYCRIGG AVE
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-4704
Mailing Address - Country:US
Mailing Address - Phone:973-653-6077
Mailing Address - Fax:877-865-6713
Practice Address - Street 1:228 AYCRIGG AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-4704
Practice Address - Country:US
Practice Address - Phone:973-653-6077
Practice Address - Fax:877-865-6713
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011369225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist