Provider Demographics
NPI:1477707651
Name:MCIVER, ELOUISE M (MS ORT/L)
Entity type:Individual
Prefix:MRS
First Name:ELOUISE
Middle Name:M
Last Name:MCIVER
Suffix:
Gender:F
Credentials:MS ORT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 E 146TH ST
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451-5702
Mailing Address - Country:US
Mailing Address - Phone:718-585-0600
Mailing Address - Fax:
Practice Address - Street 1:350 E 146TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5702
Practice Address - Country:US
Practice Address - Phone:718-585-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-14
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012708-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics