Provider Demographics
NPI:1033175955
Name:MAZARAS, JOYCE SILVIA (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:JOYCE
Middle Name:SILVIA
Last Name:MAZARAS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1034 166TH ST
Mailing Address - Street 2:2B
Mailing Address - City:BEECHHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11357-2260
Mailing Address - Country:US
Mailing Address - Phone:917-863-5766
Mailing Address - Fax:
Practice Address - Street 1:179TH ST. & LINDEN BLVD.
Practice Address - Street 2:
Practice Address - City:ST. ALBANS
Practice Address - State:NY
Practice Address - Zip Code:11425
Practice Address - Country:US
Practice Address - Phone:718-526-1000
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008561-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist