Danielle Da Costa, OTR/L

Individual provider Active NPI Occupational Therapist · Centereach, NY

NPI 1790920106 · NPPES record last updated Dec 14, 2008

Key facts

NPI
1790920106
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
011765 (NY)
Practice address
3 Countywide LN
Centereach, NY 11720-1939
Phone
(631) 775-6424
NPI assigned
Dec 14, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
011765NYMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 011765 NY Yes

Addresses

Primary practice location

3 Countywide LN
Centereach, NY 11720-1939

Mailing address

3 Countywide LN
Centereach, NY 11720-1939
Phone (631) 775-6424

Other providers in Centereach, NY

All providers in Centereach, NY · Occupational Therapist in New York

Sources for this page

Verify at the official NPI Registry.