Provider Demographics
NPI:1992950679
Name:DULASKI, CARRIE DIANE (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:DIANE
Last Name:DULASKI
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 WALNUT RD
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2227
Mailing Address - Country:US
Mailing Address - Phone:516-382-0098
Mailing Address - Fax:
Practice Address - Street 1:12 WALNUT RD
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2227
Practice Address - Country:US
Practice Address - Phone:516-382-0098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-23
Last Update Date:2008-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009176-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist