Provider Demographics
NPI:1396021879
Name:TALESNICK, MARCIA PALLEY (OTR)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:PALLEY
Last Name:TALESNICK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 BULSON RD
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-1206
Mailing Address - Country:US
Mailing Address - Phone:516-766-8639
Mailing Address - Fax:
Practice Address - Street 1:128 SHEPHERD ST
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-2257
Practice Address - Country:US
Practice Address - Phone:516-255-8928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2011-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002116-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist