Deborah Wan, OTR/L, ATR-BC, LCAT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

20654 Issued in NY

Practice address

14439 Gravett Rd
Flushing, NY 11367-1304

Phone

(718) 935-4000

NPI assigned

Oct 11, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Laura Fontaine

  • Community/Behavioral Health Agency
  • Brooklyn, NY
  • NPI 1942627062
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1841542032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14439 GRAVETT RD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14439 GRAVETT RD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113671304",
            "telephone_number": "718-935-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAN",
        "first_name": "DEBORAH",
        "credential": "OTR/L, ATR-BC, LCAT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-11",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "20654",
            "primary": true
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NY",
            "license": "1388",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya K. Walker, NP
• Cormac Walsh
• Stacie Walston
• Anne-Marie Chantelle Walters, RPA-C
• Daleel Walters, RN
• Ningxin Wan, M.D.
• Wang Chen Dental Care PLLC
• Wang Mei Obstetrics Gynecology P.C.
• Baorong Wang
• Bin Wang, MD

• Occupational Therapist in Flushing, NY
• Providers in Flushing, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.