Provider Demographics
NPI:1336352400
Name:DARGAN, MADGE (OTR)
Entity Type:Individual
Prefix:MISS
First Name:MADGE
Middle Name:
Last Name:DARGAN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 ADAMS ST
Mailing Address - Street 2:APT. 308
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-2216
Mailing Address - Country:US
Mailing Address - Phone:201-759-5918
Mailing Address - Fax:
Practice Address - Street 1:300 E 57TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2928
Practice Address - Country:US
Practice Address - Phone:212-371-2996
Practice Address - Fax:212-980-1699
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013446-1225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand