MEDICARE: MAZAL NORMATOVA

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	020285	NY

General Provider Information

NPI Number	:	1134585078
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAZAL NORMATOVA

Provider Business Mailing Address
First Line	:	8911 63RD DR
Second Line	:	APT 105
City	:	REGO PARK
State	:	NY
Zip	:	11374-3852
Country	:	US
Telephone Number	:	347-679-2955
Fax Number	:

Provider Business Practice Location Address
First Line	:	8911 63RD DR
Second Line	:	APT 105
City	:	REGO PARK
State	:	NY
Zip	:	11374-3852
Country	:	US
Telephone Number	:	347-679-2955
Fax Number	:

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

Provider Enumeration Date	:	01/07/2016
Last Update Date	:	01/07/2016

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Directions to “ MAZAL NORMATOVA ” Practice Location

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