Provider Demographics
NPI:1881930998
Name:DORSAINVIL, REGINE (OTR/L)
Entity type:Individual
Prefix:MISS
First Name:REGINE
Middle Name:
Last Name:DORSAINVIL
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 1:2217 CATON AVE
Mailing Address - Street 2:APT.6D
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-2597
Mailing Address - Country:US
Mailing Address - Phone:347-482-5511
Mailing Address - Fax:
Practice Address - Street 1:2217 CATON AVE
Practice Address - Street 2:APT.6D
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-2597
Practice Address - Country:US
Practice Address - Phone:347-482-5511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-17
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016108225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist