Provider Demographics
NPI:1588963862
Name:DELVECCHIO, DEBORAH ANN (OTR)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ANN
Last Name:DELVECCHIO
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:ANN
Other - Last Name:DEVINSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:281 WOODLAND DR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTWATERS
Mailing Address - State:NY
Mailing Address - Zip Code:11718-1920
Mailing Address - Country:US
Mailing Address - Phone:631-666-2069
Mailing Address - Fax:
Practice Address - Street 1:281 WOODLAND DR
Practice Address - Street 2:
Practice Address - City:BRIGHTWATERS
Practice Address - State:NY
Practice Address - Zip Code:11718-1920
Practice Address - Country:US
Practice Address - Phone:631-666-2069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-25
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000641225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics