Provider Demographics
NPI:1265858609
Name:ZACHAI, DEENA
Entity Type:Individual
Prefix:MISS
First Name:DEENA
Middle Name:
Last Name:ZACHAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14739 75TH RD APT 1A
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-2907
Mailing Address - Country:US
Mailing Address - Phone:917-715-3317
Mailing Address - Fax:
Practice Address - Street 1:14739 75TH RD APT 1A
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-2907
Practice Address - Country:US
Practice Address - Phone:917-715-3317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018386-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist