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General NPI Number Information
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NPI Number | 1497234652
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Entity Type | Individual
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Provider Name | CHRISTINE ROSE MORAN MS, OTR/L
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Gender | Female
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Dates
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Enumeration Date | 08/08/2018
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Last Update Date | 08/08/2018
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Provider Practice Location Address
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Address Line | 450 MAMARONECK AVE STE 412
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City | HARRISON
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State | NY
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Zip | 10528-2430
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Country | US
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Telephone | 914-686-3116
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Fax |
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Provider Business Mailing Address
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Address Line | 19 FAR HORIZONS DR
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City | BETHEL
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State | CT
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Zip | 06801-1254
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Country | US
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Telephone | 203-648-1674
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 020948-1
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License Number State | NY
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