Provider Demographics
NPI:1932447273
Name:DEEB, LORRAINE M (MS ED)
Entity Type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:M
Last Name:DEEB
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:MRS
Other - First Name:LORRAINE
Other - Middle Name:
Other - Last Name:CASTLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS ED
Mailing Address - Street 1:8823 COLONIAL RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209-5501
Mailing Address - Country:US
Mailing Address - Phone:718-491-4996
Mailing Address - Fax:718-491-4996
Practice Address - Street 1:101 TYRELLAN AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-2624
Practice Address - Country:US
Practice Address - Phone:718-281-3640
Practice Address - Fax:347-215-2088
Is Sole Proprietor?:No
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner