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NPI Code Detail

MEDICARE: MRS. MARTA ALICIA CANAAN M.S., OTR/L

MEDICARE: MRS. MARTA ALICIA CANAAN M.S., 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
1225XP0200XPediatric Occupational Therapist014186-1NY

General Provider Information

NPI Number : 1508194937
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARTA ALICIA CANAAN M.S., OTR/L
Provider Business Mailing Address
First Line : 159 20TH ST STE 3A
Second Line :
City : BROOKLYN
State : NY
Zip : 11232-1254
Country : US
Telephone Number : 347-534-7796
Fax Number : 347-799-1383
Provider Business Practice Location Address
First Line : 159 20TH ST STE 3A
Second Line :
City : BROOKLYN
State : NY
Zip : 11232-1254
Country : US
Telephone Number : 347-534-7796
Fax Number : 347-799-1383
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2009
Last Update Date : 10/31/2016

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