Provider Demographics
NPI:1063205060
Name:DENG, WARREN (OTR/L)
Entity type:Individual
Prefix:
First Name:WARREN
Middle Name:
Last Name:DENG
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 1:2821 W 17TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-2611
Mailing Address - Country:US
Mailing Address - Phone:347-449-8731
Mailing Address - Fax:
Practice Address - Street 1:110 CHESTER ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-5643
Practice Address - Country:US
Practice Address - Phone:718-385-6200
Practice Address - Fax:718-345-3021
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030046225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist