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NPI Code Detail

MEDICARE: KERRY A MARINO OTR

MEDICARE: KERRY A MARINO 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
1225X00000XOccupational Therapist0203241NY

General Provider Information

NPI Number : 1881053429
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERRY A MARINO OTR
Provider Business Mailing Address
First Line : 400 PAUL CT
Second Line :
City : WEST HEMPSTEAD
State : NY
Zip : 11552-2815
Country : US
Telephone Number : 516-330-7288
Fax Number :
Provider Business Practice Location Address
First Line : 669 BROADWAY
Second Line :
City : MASSAPEQUA
State : NY
Zip : 11758-2314
Country : US
Telephone Number : 516-799-2900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/10/2016
Last Update Date : 11/01/2019

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