Provider Demographics
NPI:1922564095
Name:DEBEAR, KIRSTEN NORSKOV (OTR, MSED)
Entity Type:Individual
Prefix:MS
First Name:KIRSTEN
Middle Name:NORSKOV
Last Name:DEBEAR
Suffix:
Gender:F
Credentials:OTR, MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 W END AVE APT 11A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-2725
Mailing Address - Country:US
Mailing Address - Phone:917-621-5306
Mailing Address - Fax:
Practice Address - Street 1:545 W END AVE APT 11A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-2725
Practice Address - Country:US
Practice Address - Phone:917-621-5306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-14
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000636-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics