Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 010734 | NY |
NPI | 1992947360 |
---|---|
Provider Name | Mrs. Dawn Marie Maratta-Kielb |
First Address | Staten Island, NY 10308-1920 |
Second Address | Staten Island, NY 10308-1920 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2009 |
Last Update Date | 01/04/2009 |