Provider Demographics
NPI:1609372374
Name:MARESCA, KATE MARY (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:MARY
Last Name:MARESCA
Suffix:
Gender:F
Credentials:MS, OTR/L
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Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:PO BOX 630
Mailing Address - Street 2:
Mailing Address - City:EAST GREENBUSH
Mailing Address - State:NY
Mailing Address - Zip Code:12061-0630
Mailing Address - Country:US
Mailing Address - Phone:518-233-0544
Mailing Address - Fax:518-233-0703
Practice Address - Street 1:199 SCHOOLHOUSE RD
Practice Address - Street 2:
Practice Address - City:STUYVESANT
Practice Address - State:NY
Practice Address - Zip Code:12173-1803
Practice Address - Country:US
Practice Address - Phone:518-755-4793
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022377225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist