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General NPI Number Information
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NPI Number | 1295943355
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Entity Type | Individual
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Provider Name | MARSHA MCGOGNEY OTL
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Gender | Female
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Dates
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Enumeration Date | 05/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 412 AVENUE OF THE AMERICAS SUITE 408-409
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City | NEW YORK
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State | NY
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Zip | 10011-8409
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Country | US
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Telephone | 212-627-4545
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Fax |
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Provider Business Mailing Address
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Address Line | 37 WALL ST APT. 5R
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City | NEW YORK
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State | NY
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Zip | 10005-1917
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Country | US
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Telephone | 212-501-6781
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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 | 007832
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License Number State | NY
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