Healthcare Provider Details

I. General information

NPI: 1316569684
Provider Name (Legal Business Name): VIJAY ASISH MUNI MS, OTR/L, CHT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2020
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11608 MYRTLE AVE STE 307
RICHMOND HILL NY
11418-1748
US

IV. Provider business mailing address

6157 AUSTIN ST
REGO PARK NY
11374-1031
US

V. Phone/Fax

Practice location:
  • Phone: 347-639-5662
  • Fax:
Mailing address:
  • Phone: 347-639-5662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number024683-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: