Provider Demographics
NPI:1023260387
Name:DUVALL, ROBERT EDWARD (OTR/L)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:EDWARD
Last Name:DUVALL
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 1:28 MEARNS AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:10928-1104
Mailing Address - Country:US
Mailing Address - Phone:914-224-3090
Mailing Address - Fax:
Practice Address - Street 1:28 MEARNS AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND FALLS
Practice Address - State:NY
Practice Address - Zip Code:10928-1104
Practice Address - Country:US
Practice Address - Phone:914-224-3090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-17
Last Update Date:2018-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY012281OtherNYS CERTIFICATION # FOR OCCUPATIONAL THERAPISTS