Provider Demographics
NPI:1790930576
Name:CALLAGHAN, MARIA (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:CALLAGHAN
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 1:555 EDGECOMBE AVE
Mailing Address - Street 2:SUITE 6D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-4406
Mailing Address - Country:US
Mailing Address - Phone:212-928-2040
Mailing Address - Fax:212-928-4049
Practice Address - Street 1:555 EDGECOMBE AVE
Practice Address - Street 2:SUITE 6D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-4406
Practice Address - Country:US
Practice Address - Phone:212-928-2040
Practice Address - Fax:212-928-4049
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013193-1225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics