Provider Demographics
NPI:1275871667
Name:LIRIANO, JAY EMANUEL (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:JAY
Middle Name:EMANUEL
Last Name:LIRIANO
Suffix:
Gender:M
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 1:659 E 158TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10456-7759
Mailing Address - Country:US
Mailing Address - Phone:347-203-1129
Mailing Address - Fax:
Practice Address - Street 1:659 E 158TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10456-7759
Practice Address - Country:US
Practice Address - Phone:347-203-1129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-21
Last Update Date:2013-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017814225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist