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General NPI Number Information
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NPI Number | 1770977357
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Entity Type | Individual
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Provider Name | BRIAN CIMMINO MS OTR/L
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Gender | Male
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Dates
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Enumeration Date | 03/23/2015
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Last Update Date | 03/23/2015
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Provider Practice Location Address
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Address Line | 1121 KEELER AVE
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City | MAMARONECK
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State | NY
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Zip | 10543-2938
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Country | US
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Telephone | 914-552-6129
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Fax |
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Provider Business Mailing Address
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Address Line | 1121 KEELER AVE
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City | MAMARONECK
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State | NY
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Zip | 10543-2938
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Country | US
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Telephone | 914-552-6129
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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 | 0188201
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 115784
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 11111
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 003745
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License Number State | CT
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