Provider Demographics
NPI:1407802630
Name:LARKIN, MARY E (PT)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:LARKIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3839 MERRICK RD
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:NY
Mailing Address - Zip Code:11783-2839
Mailing Address - Country:US
Mailing Address - Phone:516-802-2895
Mailing Address - Fax:516-802-2897
Practice Address - Street 1:3839 MERRICK RD
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:NY
Practice Address - Zip Code:11783-2839
Practice Address - Country:US
Practice Address - Phone:516-802-2895
Practice Address - Fax:516-802-2897
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25529225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ14D5Q4FH1OtherMEDICARE PTAN
NYQ14D5Q4FH1OtherMEDICARE PTAN