Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 013981 | NY |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 013981 | NY |
NPI | 1063056273 |
---|---|
Provider Name | Cristina Scardillo-Mariani |
First Address | Great Neck, NY 11021-4802 |
Second Address | Great Neck, NY 11021 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2019 |
Last Update Date | 05/11/2019 |