MEDICARE: MS. MAYA SHKOLNIK 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	022479	NY

General Provider Information

NPI Number	:	1346713070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MAYA SHKOLNIK OTR/L

Provider Business Mailing Address
First Line	:	145 FRONT ST UNIT 1223
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01608-1450
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 FRONT ST UNIT 1223
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01608-1450
Country	:	US
Telephone Number	:	917-403-8806
Fax Number	:

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

Provider Enumeration Date	:	01/04/2019
Last Update Date	:	04/04/2022

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