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General NPI Number Information
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NPI Number | 1235493446
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Entity Type | Individual
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Provider Name | MARY MAY A. VENZON OTR/L
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Gender | Female
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Dates
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Enumeration Date | 07/02/2012
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Last Update Date | 07/02/2012
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Provider Practice Location Address
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Address Line | 11919 GRAHAM CT COLLEGE POINT
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City | FLUSHING
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State | NY
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Zip | 11354-1047
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Country | US
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Telephone | 718-886-0700
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Fax |
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Provider Business Mailing Address
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Address Line | 5304 80TH ST
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City | ELMHURST
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State | NY
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Zip | 11373-4732
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Country | US
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Telephone | 917-214-1428
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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 | 013860
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License Number State | NY
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