Provider Demographics
NPI:1518426097
Name:MARACIC, EMILY MARIE
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:MARACIC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SHELLEY DR
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-8525
Mailing Address - Country:US
Mailing Address - Phone:516-477-7034
Mailing Address - Fax:
Practice Address - Street 1:669 BROADWAY
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-2314
Practice Address - Country:US
Practice Address - Phone:516-799-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist