Provider Demographics
NPI:1912196106
Name:ANTOINE, YVES-MARIE (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:YVES-MARIE
Middle Name:
Last Name:ANTOINE
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 DECATUR ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11233-1804
Mailing Address - Country:US
Mailing Address - Phone:718-778-1770
Mailing Address - Fax:
Practice Address - Street 1:343 DECATUR ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11233-1804
Practice Address - Country:US
Practice Address - Phone:718-778-1770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011103-1225XN1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation