Provider Demographics
NPI:1538496864
Name:JOSEPH, MAGDALEN (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:MAGDALEN
Middle Name:
Last Name:JOSEPH
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 BROOKHAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-2041
Mailing Address - Country:US
Mailing Address - Phone:718-337-5373
Mailing Address - Fax:
Practice Address - Street 1:7520 ASTORIA BLVD
Practice Address - Street 2:REHAB DEPARTMENT
Practice Address - City:EAST ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11370-1138
Practice Address - Country:US
Practice Address - Phone:718-888-6920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010871-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist