Healthcare Provider Details

I. General information

NPI: 1871021626
Provider Name (Legal Business Name): MAUREEN PRITCHARD OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2017
Last Update Date: 05/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

774 MANOR RD
STATEN ISLAND NY
10314-7038
US

IV. Provider business mailing address

353 BAY RIDGE PKWY APT 1D
BROOKLYN NY
11209-3133
US

V. Phone/Fax

Practice location:
  • Phone: 718-983-0757
  • Fax:
Mailing address:
  • Phone: 718-702-8237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number021469
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number021469
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: