Individual
MARVIN MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
6800 JERICHO TPKE STE 120W, SYOSSET, NY 11791-4445
(516) 393-5966
Mailing address
4103 OVERLOOK CIR, PIERMONT, NY 10968-1290
(845) 548-8670
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
009684
NY
Other
Enumeration date
04/11/2018
Last updated
04/11/2018
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