Healthcare Provider Details

I. General information

NPI: 1841198652
Provider Name (Legal Business Name): MAYA J ISKOWITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/30/2026
Last Update Date: 10/30/2026
Certification Date: 10/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2415 N TRIPHAMMER RD STE 11
ITHACA NY
14850-1093
US

IV. Provider business mailing address

319 ITHACA RD
ITHACA NY
14850-4817
US

V. Phone/Fax

Practice location:
  • Phone: 607-227-4421
  • Fax:
Mailing address:
  • Phone: 732-447-8147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: