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General NPI Number Information
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NPI Number | 1477824696
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Entity Type | Individual
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Provider Name | MARION OTTEN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/19/2012
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Last Update Date | 01/19/2012
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Provider Practice Location Address
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Address Line | 525 HALF HOLLOW RD
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City | DIX HILLS
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State | NY
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Zip | 11746-5828
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Country | US
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Telephone | 631-592-3008
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Fax |
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Provider Business Mailing Address
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Address Line | 7 S HARRISON AVE
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City | EAST ISLIP
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State | NY
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Zip | 11730-2313
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Country | US
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Telephone | 631-224-7022
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 003523-1
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License Number State | NY
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