Healthcare Provider Details

I. General information

NPI: 1194657999
Provider Name (Legal Business Name): ELISE MAIORANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ELM ST
TUCKAHOE NY
10707-3925
US

IV. Provider business mailing address

8212 151ST AVE # AXE
HOWARD BEACH NY
11414-1793
US

V. Phone/Fax

Practice location:
  • Phone: 201-452-0870
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: