=====================================================
General NPI Number Information
=====================================================
NPI Number | 1447496575
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MARAMING CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/18/2008
-----------------------------------------------------
Last Update Date | 12/18/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6115 97TH ST APT 7H
-----------------------------------------------------
City | REGO PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11374-1210
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-908-6545
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6115 97TH ST APT 7H
-----------------------------------------------------
City | REGO PARK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11374-1210
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-908-6545
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OCCUPATIONAL THERAPIST
-----------------------------------------------------
Name | MS. JULIA QUINONES
-----------------------------------------------------
Credential | OTR/L
-----------------------------------------------------
Telephone | 718-908-6545
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 252Y00000X
-----------------------------------------------------
Taxonomy Name | Early Intervention Provider Agency
-----------------------------------------------------
License Number | 13677-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------