Healthcare Provider Details

I. General information

NPI: 1265397988
Provider Name (Legal Business Name): ISABELLA MORICH OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 BEVERLY ST
ISLIP NY
11751-1629
US

IV. Provider business mailing address

21 BEVERLY ST
ISLIP NY
11751-1629
US

V. Phone/Fax

Practice location:
  • Phone: 631-894-8163
  • Fax:
Mailing address:
  • Phone: 631-894-8163
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number029601-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: