Provider Demographics
NPI:1386027274
Name:DELA SANTA-PURA, KAREN (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:DELA SANTA-PURA
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 1:8917 97TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODHAVEN
Mailing Address - State:NY
Mailing Address - Zip Code:11421-2725
Mailing Address - Country:US
Mailing Address - Phone:347-415-5558
Mailing Address - Fax:
Practice Address - Street 1:8917 97TH ST
Practice Address - Street 2:
Practice Address - City:WOODHAVEN
Practice Address - State:NY
Practice Address - Zip Code:11421-2725
Practice Address - Country:US
Practice Address - Phone:347-415-5558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-09
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018171225X00000X
CA15051225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist