Provider Demographics
NPI:1508194937
Name:CANAAN, MARTA ALICIA (MS, OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:MARTA
Middle Name:ALICIA
Last Name:CANAAN
Suffix:
Gender:F
Credentials:MS, OTR/L
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Other - First Name:
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Mailing Address - Street 1:159 20TH ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11232-1254
Mailing Address - Country:US
Mailing Address - Phone:347-534-7796
Mailing Address - Fax:347-799-1383
Practice Address - Street 1:159 20TH ST STE 3A
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11232-1254
Practice Address - Country:US
Practice Address - Phone:347-534-7796
Practice Address - Fax:347-799-1383
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-23
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY014186-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics