MEDICARE: MARYBEL CUEVAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	017487-1	NY

General Provider Information

NPI Number	:	1053669697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARYBEL CUEVAS

Provider Business Mailing Address
First Line	:	368 W 117TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10026-1567
Country	:	US
Telephone Number	:	917-843-3538
Fax Number	:

Provider Business Practice Location Address
First Line	:	368 W 117TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10026-1567
Country	:	US
Telephone Number	:	917-843-3538
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2012
Last Update Date	:	08/28/2012

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Directions to “ MARYBEL CUEVAS ” Practice Location

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