Provider Demographics
NPI:1407978109
Name:BECKER, DENISE JOAN (OT)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:JOAN
Last Name:BECKER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 FRANCIS AVE
Mailing Address - Street 2:#5C
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-1925
Mailing Address - Country:US
Mailing Address - Phone:917-679-2854
Mailing Address - Fax:
Practice Address - Street 1:260 68TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-5201
Practice Address - Country:US
Practice Address - Phone:718-833-6633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004001225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist