Provider Demographics
NPI:1255635447
Name:SADIGHI, MARIAM (OTR)
Entity type:Individual
Prefix:
First Name:MARIAM
Middle Name:
Last Name:SADIGHI
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 1:13 WESTLAND DR
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-1013
Mailing Address - Country:US
Mailing Address - Phone:516-676-0631
Mailing Address - Fax:516-676-8147
Practice Address - Street 1:13 WESTLAND DR
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-1013
Practice Address - Country:US
Practice Address - Phone:516-676-0631
Practice Address - Fax:516-676-8147
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-02
Last Update Date:2011-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005115-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist