Healthcare Provider Details

I. General information

NPI: 1336033901
Provider Name (Legal Business Name): MV OCCUPATIONAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 MARINERS WAY
EDGARTOWN MA
02539
US

IV. Provider business mailing address

PO BOX 1524
OAK BLUFFS MA
02557-1524
US

V. Phone/Fax

Practice location:
  • Phone: 774-549-2270
  • Fax: 508-202-0029
Mailing address:
  • Phone: 617-642-2384
  • Fax: 508-202-0029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH ZELLER
Title or Position: OWNER
Credential: OTR/L
Phone: 774-549-2270