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NPI Code Detail

MEDICARE: MARC VIERA

MEDICARE:   MARC  VIERA
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
1224Z00000XOccupational Therapy AssistantOTA00373RI
2224Z00000XOccupational Therapy Assistant3006MA

General Provider Information

NPI Number : 1265556732
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARC VIERA
Provider Business Mailing Address
First Line : PO BOX 40822
Second Line :
City : PROVIDENCE
State : RI
Zip : 02940-0838
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 17 GEM ST
Second Line :
City : NORTH PROVIDENCE
State : RI
Zip : 02904-4805
Country : US
Telephone Number : 401-258-1237
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 07/08/2007

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Directions to “ MARC VIERA ” Practice Location

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