Provider Demographics
NPI:1588813638
Name:MAH, JULIANA W (MA OTR/L)
Entity Type:Individual
Prefix:
First Name:JULIANA
Middle Name:W
Last Name:MAH
Suffix:
Gender:F
Credentials:MA OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23308 41ST AVE
Mailing Address - Street 2:
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11363-1522
Mailing Address - Country:US
Mailing Address - Phone:718-309-8685
Mailing Address - Fax:
Practice Address - Street 1:23308 41ST AVE
Practice Address - Street 2:
Practice Address - City:DOUGLASTON
Practice Address - State:NY
Practice Address - Zip Code:11363-1522
Practice Address - Country:US
Practice Address - Phone:718-309-8685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-13
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007598225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics