Provider Demographics
NPI:1912151333
Name:CHIN, DEANNE M (OTR/L)
Entity Type:Individual
Prefix:
First Name:DEANNE
Middle Name:M
Last Name:CHIN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:DEANNE
Other - Middle Name:M
Other - Last Name:TARDIFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:4 DEER RUN CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-3629
Mailing Address - Country:US
Mailing Address - Phone:917-846-3058
Mailing Address - Fax:
Practice Address - Street 1:4 DEER RUN CT
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-3629
Practice Address - Country:US
Practice Address - Phone:917-846-3058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
011662-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics