Provider Demographics
NPI:1629309257
Name:ORR, OFER (LMT)
Entity Type:Individual
Prefix:MR
First Name:OFER
Middle Name:
Last Name:ORR
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17328 MAYFIELD RD
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-2138
Mailing Address - Country:US
Mailing Address - Phone:917-562-3402
Mailing Address - Fax:
Practice Address - Street 1:17328 MAYFIELD RD
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-2138
Practice Address - Country:US
Practice Address - Phone:917-562-3402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-21
Last Update Date:2010-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023102-1225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist