Individual
DEBORAH DERISO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2128 68TH STREET, BROOKLYN, NY 11204
(917) 686-4827
Mailing address
2128 68TH STREET, BROOKLYN, NY 11204
(917) 686-4827
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
004989-1
NY
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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