Provider Demographics
NPI:1699485425
Name:DURITY-CHOONOO, TAIEL
Entity type:Individual
Prefix:
First Name:TAIEL
Middle Name:
Last Name:DURITY-CHOONOO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 14TH AVE # 36B
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-3506
Mailing Address - Country:US
Mailing Address - Phone:551-486-1915
Mailing Address - Fax:
Practice Address - Street 1:2 14TH AVE # 36B
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-3506
Practice Address - Country:US
Practice Address - Phone:551-486-1915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-02
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist