Provider Demographics
NPI:1568607067
Name:TOBON, KEREN K (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:KEREN
Middle Name:K
Last Name:TOBON
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:KEREN
Other - Middle Name:K
Other - Last Name:ABREU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:40 VILLAGE GRN UNIT 397
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NY
Mailing Address - Zip Code:10506-7018
Mailing Address - Country:US
Mailing Address - Phone:914-306-0863
Mailing Address - Fax:
Practice Address - Street 1:50 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-2848
Practice Address - Country:US
Practice Address - Phone:914-306-0863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-11
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014184-1225XP0200X
225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty