Provider Demographics
NPI:1407070626
Name:INOUE, ANN RIKER (MS,OTR,LLCC)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:RIKER
Last Name:INOUE
Suffix:
Gender:F
Credentials:MS,OTR,LLCC
Other - Prefix:MS
Other - First Name:ANN
Other - Middle Name:ELIZABETH
Other - Last Name:RIKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:285 SILLS RD. BLDG 18
Mailing Address - Street 2:
Mailing Address - City:PATCHOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11772-4808
Mailing Address - Country:US
Mailing Address - Phone:631-475-1224
Mailing Address - Fax:631-475-1588
Practice Address - Street 1:285 SILLS RD. BLDG 5-6
Practice Address - Street 2:SUITE B
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-4808
Practice Address - Country:US
Practice Address - Phone:631-475-2858
Practice Address - Fax:631-475-2886
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2008-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002562-1225X00000X, 225XH1200X, 225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation