Provider Demographics
NPI:1174725568
Name:ABIERA, DEXTER GAMALIEL JR (OTR)
Entity type:Individual
Prefix:MR
First Name:DEXTER
Middle Name:GAMALIEL
Last Name:ABIERA
Suffix:JR
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1938 EDISON AVE APT 1R
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-4076
Mailing Address - Country:US
Mailing Address - Phone:347-621-4646
Mailing Address - Fax:
Practice Address - Street 1:245 E 149TH ST
Practice Address - Street 2:4C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5516
Practice Address - Country:US
Practice Address - Phone:718-993-2710
Practice Address - Fax:718-402-6586
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013486225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist