MEDICARE: MARLA HARTY

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	225XP0200X	Pediatric Occupational Therapist	006613	NY

General Provider Information

NPI Number	:	1265739965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLA HARTY

Provider Business Mailing Address
First Line	:	3349 JUNCTION BLVD
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-2031
Country	:	US
Telephone Number	:	718-478-7970
Fax Number	:

Provider Business Practice Location Address
First Line	:	3349 JUNCTION BLVD
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-2031
Country	:	US
Telephone Number	:	718-478-7970
Fax Number	:

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

Provider Enumeration Date	:	02/16/2011
Last Update Date	:	02/16/2011

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Directions to “ MARLA HARTY ” Practice Location

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