MEDICARE: SAMANTHA MARIE FERRARO 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	020485-1	NY

General Provider Information

NPI Number	:	1598117392
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA MARIE FERRARO OTR/L

Provider Business Mailing Address
First Line	:	566 MAIN ST
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10307-1730
Country	:	US
Telephone Number	:	718-702-7014
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 DURANT AVE
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10308-3030
Country	:	US
Telephone Number	:	718-987-8020
Fax Number	:

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

Provider Enumeration Date	:	07/06/2016
Last Update Date	:	03/06/2026

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