Provider Demographics
NPI:1992017248
Name:DIEN, JUDITH (OTR/L)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:DIEN
Suffix:
Gender:F
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 1:5800 ARLINGTON AVE
Mailing Address - Street 2:#22U
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-1402
Mailing Address - Country:US
Mailing Address - Phone:718-543-3535
Mailing Address - Fax:
Practice Address - Street 1:5800 ARLINGTON AVE
Practice Address - Street 2:#22U
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-1402
Practice Address - Country:US
Practice Address - Phone:718-543-3535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-01
Last Update Date:2010-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001905-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics