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Organization

REHABILITATION

Active
Other names
mitchell martin
Organization subpart
No

Provider details

NPI number
Authorized official
MS. MARINA MATTEI I O.T.A. (OCCUPATIONAL THERAPIST ASSISTANT)
(917) 470-7040
Entity
Organization

Contact information

Practice address
210 E 102ND ST, #13H, NEW YORK, NY 10029-5937
(212) 876-0659
(212) 876-0659
Mailing address
210 E 102ND ST, #13H, NEW YORK, NY 10029-5937
(212) 876-0659
(212) 876-0659

Taxonomy

Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
003295-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
003295-1
LICENSURE
NY
Enumeration date
12/17/2006
Last updated
08/22/2020
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