Individual
DJAVAN DEANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
55 POST AVE, WESTBURY, NY 11590-4361
(516) 338-5327
Mailing address
774 JEFFERSON STREET, BALDWIN, NY 11510
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
020947
NY
Other
Enumeration date
08/22/2017
Last updated
08/22/2017
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