MEDICARE: MELANIE CELESTE AUSTIN OTR

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	011559	NY

General Provider Information

NPI Number	:	1538281258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE CELESTE AUSTIN OTR

Provider Business Mailing Address
First Line	:	38 BERKSHIRE RD
Second Line	:
City	:	WEST BABYLON
State	:	NY
Zip	:	11704-6613
Country	:	US
Telephone Number	:	718-938-3215
Fax Number	:

Provider Business Practice Location Address
First Line	:	38 BERKSHIRE RD
Second Line	:
City	:	WEST BABYLON
State	:	NY
Zip	:	11704-6613
Country	:	US
Telephone Number	:	718-938-3215
Fax Number	:

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

Provider Enumeration Date	:	04/04/2007
Last Update Date	:	07/08/2007

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