Provider Demographics
NPI:1326305335
Name:HOWARD, ANTOINETTE (OTR/L)
Entity Type:Individual
Prefix:
First Name:ANTOINETTE
Middle Name:
Last Name:HOWARD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:TONI
Other - Middle Name:
Other - Last Name:MARVULLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21 ADAMS DR
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980-1022
Mailing Address - Country:US
Mailing Address - Phone:845-942-4547
Mailing Address - Fax:
Practice Address - Street 1:260 N LITTLE TOR RD
Practice Address - Street 2:JAWONIO
Practice Address - City:NEW CITY
Practice Address - State:NY
Practice Address - Zip Code:10956-2627
Practice Address - Country:US
Practice Address - Phone:845-708-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-15
Last Update Date:2012-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009292225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist