Provider Demographics
NPI:1699919621
Name:DEONARAIN, PRIYA DARSHANI
Entity type:Individual
Prefix:MS
First Name:PRIYA
Middle Name:DARSHANI
Last Name:DEONARAIN
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 1:116-12 150TH AVENUE
Mailing Address - Street 2:SOUTH OZONE PARK
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11420
Mailing Address - Country:US
Mailing Address - Phone:646-309-4942
Mailing Address - Fax:
Practice Address - Street 1:11612 150TH AVE
Practice Address - Street 2:SOUTH OZONE PARK
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11420-3911
Practice Address - Country:US
Practice Address - Phone:646-309-4942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-21
Last Update Date:2010-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014124-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics