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NPI Code Detail

MEDICARE: MRS. MIRIAM TARLOW OTR/L

MEDICARE: MRS. MIRIAM TARLOW 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
1171W00000XContractor011558NY

General Provider Information

NPI Number : 1649410424
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MIRIAM TARLOW OTR/L
Provider Business Mailing Address
First Line : 649 39TH STREET
Second Line : CHALLENGE EARLY INTERVENTION CENTER
City : BROOKLYN
State : NY
Zip : 11232
Country : US
Telephone Number : 718-972-0880
Fax Number : 718-972-0696
Provider Business Practice Location Address
First Line : 649 39TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11232-3101
Country : US
Telephone Number : 718-972-0880
Fax Number : 718-972-0696
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2009
Last Update Date : 03/06/2009

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