Provider Demographics
NPI:1467868760
Name:DAVID, VERENA ANNE (OTR)
Entity Type:Individual
Prefix:
First Name:VERENA ANNE
Middle Name:
Last Name:DAVID
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:V. ANNE
Other - Middle Name:
Other - Last Name:DAVID
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR
Mailing Address - Street 1:925 E 14TH ST APT 6D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-3618
Mailing Address - Country:US
Mailing Address - Phone:917-304-3657
Mailing Address - Fax:718-451-5235
Practice Address - Street 1:475 E 57TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-6010
Practice Address - Country:US
Practice Address - Phone:718-451-5213
Practice Address - Fax:718-451-5235
Is Sole Proprietor?:No
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005555225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist