Individual
MS. CAROLYN DEKANCHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA/L
Contact information
Practice address
25523 MEMPHIS AVE, ROSEDALE, NY 11422-2553
(516) 330-1206
Mailing address
25523 MEMPHIS AVE, ROSEDALE, NY 11422-2553
(516) 330-1206
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0070731
NY
Other
Enumeration date
08/27/2014
Last updated
08/27/2014
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