MEDICARE: ROBERT LOUIS MARIN OT

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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	023040-1	OTHER	NY	LICENSE

General Provider Information

NPI Number	:	1346871373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT LOUIS MARIN OT

Provider Business Mailing Address
First Line	:	131 W 135TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10030-2922
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	131 W 135TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10030-2922
Country	:	US
Telephone Number	:	646-448-4900
Fax Number	:	646-448-4966

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

Provider Enumeration Date	:	01/29/2020
Last Update Date	:	01/29/2020

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Directions to “ ROBERT LOUIS MARIN OT” Practice Location

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