Healthcare Provider Details

I. General information

NPI: 1477894723
Provider Name (Legal Business Name): MARILYN ANN ROSEE OT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARILYN LEVENSON OT

II. Dates (important events)

Enumeration Date: 03/12/2013
Last Update Date: 03/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 E 68TH ST APT 5RS
NEW YORK NY
10065-5692
US

IV. Provider business mailing address

315 E 68TH ST APT 5RS
NEW YORK NY
10065-5692
US

V. Phone/Fax

Practice location:
  • Phone: 212-879-0816
  • Fax: 646-218-3760
Mailing address:
  • Phone: 212-879-0816
  • Fax: 646-218-3760

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number002244-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: