Provider Demographics
NPI:1659526564
Name:MARYLES, JULIA BETH (MA OTR/L)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:BETH
Last Name:MARYLES
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 1:382 MIDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1610
Mailing Address - Country:US
Mailing Address - Phone:516-791-3258
Mailing Address - Fax:516-791-3258
Practice Address - Street 1:382 MIDWOOD RD
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1610
Practice Address - Country:US
Practice Address - Phone:516-791-3258
Practice Address - Fax:516-791-3258
Is Sole Proprietor?:No
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007339-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist