Provider Demographics
NPI:1841634763
Name:DOBOSZ, JEANNETTE MARIE (OTR/L)
Entity type:Individual
Prefix:MS
First Name:JEANNETTE
Middle Name:MARIE
Last Name:DOBOSZ
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 1:173 MAUJER ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-1332
Mailing Address - Country:US
Mailing Address - Phone:917-586-1206
Mailing Address - Fax:
Practice Address - Street 1:173 MAUJER ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-1332
Practice Address - Country:US
Practice Address - Phone:917-586-1206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-22
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018019225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics