Provider Demographics
NPI:1740802016
Name:MARUT, PATRICIA (OTR/L)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:MARUT
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 1:12 PERRY RD
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02170-3421
Mailing Address - Country:US
Mailing Address - Phone:617-687-9266
Mailing Address - Fax:
Practice Address - Street 1:300 1ST AVE
Practice Address - Street 2:
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129-3109
Practice Address - Country:US
Practice Address - Phone:617-952-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-10
Last Update Date:2020-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13149225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist