Provider Demographics
NPI:1942587779
Name:WHITAKER, MARIAN K (OTR)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:K
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 ESPLANADE
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-2400
Mailing Address - Country:US
Mailing Address - Phone:914-738-4235
Mailing Address - Fax:
Practice Address - Street 1:514 ESPLANADE
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-2400
Practice Address - Country:US
Practice Address - Phone:914-738-4235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001822-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist