Provider Demographics
NPI:1316569684
Name:MUNI, VIJAY ASISH (MS, OTR/L)
Entity Type:Individual
Prefix:MR
First Name:VIJAY
Middle Name:ASISH
Last Name:MUNI
Suffix:
Gender:M
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6157 AUSTIN ST
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-1031
Mailing Address - Country:US
Mailing Address - Phone:347-639-5662
Mailing Address - Fax:
Practice Address - Street 1:6157 AUSTIN ST
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-1031
Practice Address - Country:US
Practice Address - Phone:347-639-5662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-10
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024683-01225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist