Provider Demographics
NPI:1174752695
Name:HANGES, DIANE ANASTACIA (OTR)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:ANASTACIA
Last Name:HANGES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:589 VALLEY AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-1933
Mailing Address - Country:US
Mailing Address - Phone:914-844-2563
Mailing Address - Fax:
Practice Address - Street 1:589 VALLEY AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-1933
Practice Address - Country:US
Practice Address - Phone:914-844-2563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001429225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist