Healthcare Provider Details

I. General information

NPI: 1801404371
Provider Name (Legal Business Name): DANIELLE BARILLARO MOT, OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2020
Last Update Date: 07/21/2020
Certification Date: 07/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3391 RICHMOND AVE
STATEN ISLAND NY
10312-2025
US

IV. Provider business mailing address

1110 STADIUM AVE APT 4H
BRONX NY
10465-1536
US

V. Phone/Fax

Practice location:
  • Phone: 718-608-9170
  • Fax:
Mailing address:
  • Phone: 845-238-9290
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: