Provider Demographics
NPI:1376928051
Name:MAUREAL, MARY LOUVAIN GARCIANO (OTR/L)
Entity type:Individual
Prefix:
First Name:MARY LOUVAIN
Middle Name:GARCIANO
Last Name:MAUREAL
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 1:1707 DEAN ST APT 4A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-6095
Mailing Address - Country:US
Mailing Address - Phone:408-966-9158
Mailing Address - Fax:
Practice Address - Street 1:5923 STRICKLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-6435
Practice Address - Country:US
Practice Address - Phone:718-535-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-23
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY01798201225X00000X
NY017982-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist