Provider Demographics
NPI:1801853924
Name:DEEMER, LARRY EDWARD (MA OTR,L)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:EDWARD
Last Name:DEEMER
Suffix:
Gender:M
Credentials:MA OTR,L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 ATLANTIC WALK
Mailing Address - Street 2:
Mailing Address - City:BREEZY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11697-1815
Mailing Address - Country:US
Mailing Address - Phone:718-474-2835
Mailing Address - Fax:
Practice Address - Street 1:800 POLY PL
Practice Address - Street 2:PM&R, 2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-7104
Practice Address - Country:US
Practice Address - Phone:718-836-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007871-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist