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General NPI Number Information
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NPI Number | 1194083246
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Entity Type | Individual
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Provider Name | JOSEPH MIRAGLIA MA, OTR/L
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Gender | Male
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Dates
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Enumeration Date | 04/26/2012
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Last Update Date | 04/26/2012
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Provider Practice Location Address
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Address Line | 9045 MYRTLE AVE
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City | GLENDALE
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State | NY
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Zip | 11385-7823
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Country | US
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Telephone | 718-849-3002
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Fax |
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Provider Business Mailing Address
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Address Line | 3000 SPOUT RUN PKWY APT D309
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City | ARLINGTON
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State | VA
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Zip | 22201-4232
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 006933-1
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License Number State | NY
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