Provider Demographics
NPI:1457617904
Name:ESTEVEZ, DAMARIS ALTAGRACIA (OTR/L)
Entity Type:Individual
Prefix:
First Name:DAMARIS
Middle Name:ALTAGRACIA
Last Name:ESTEVEZ
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 1:3223 POPLAR ST
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2621
Mailing Address - Country:US
Mailing Address - Phone:646-319-6363
Mailing Address - Fax:
Practice Address - Street 1:3223 POPLAR ST
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-2621
Practice Address - Country:US
Practice Address - Phone:646-319-6363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014470-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist