Provider Demographics
NPI:1538434527
Name:DUMAS, MARC (OTR/L)
Entity type:Individual
Prefix:MR
First Name:MARC
Middle Name:
Last Name:DUMAS
Suffix:
Gender:M
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:PO BOX 130302
Mailing Address - Street 2:ST JOHN'S STATION
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-0302
Mailing Address - Country:US
Mailing Address - Phone:347-267-0352
Mailing Address - Fax:
Practice Address - Street 1:3465 192ND ST
Practice Address - Street 2:PS 233@ IS 25 (RM B30)
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11358-1926
Practice Address - Country:US
Practice Address - Phone:718-886-3456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011320-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist