MEDICARE: MARIA SCIANDRA OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	020423-1	NY

General Provider Information

NPI Number	:	1124482278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA SCIANDRA OTR/L

Provider Business Mailing Address
First Line	:	21 FINGAL ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-4903
Country	:	US
Telephone Number	:	917-620-1502
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 FINGAL ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10312-4903
Country	:	US
Telephone Number	:	917-620-1502
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/05/2016
Last Update Date	:	08/04/2016

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