Provider Demographics
NPI:1437304425
Name:MARSHALL, VIRGINIA (OTR)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:
Last Name:MARSHALL
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 1:10 W 86TH ST
Mailing Address - Street 2:APARTMENT 8B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-3606
Mailing Address - Country:US
Mailing Address - Phone:212-362-2745
Mailing Address - Fax:
Practice Address - Street 1:10 W 86TH ST
Practice Address - Street 2:APT.8B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3606
Practice Address - Country:US
Practice Address - Phone:212-362-2745
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001952-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics