Provider Demographics
NPI:1669771135
Name:CONMY, MARIE CATHERINE (OTR)
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:CATHERINE
Last Name:CONMY
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:MS
Other - First Name:MARIE
Other - Middle Name:CATHERINE
Other - Last Name:LEEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:794 FRANKLIN AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-1379
Mailing Address - Country:US
Mailing Address - Phone:201-891-6100
Mailing Address - Fax:018-917-7002
Practice Address - Street 1:794 FRANKLIN AVE STE 204
Practice Address - Street 2:
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-1379
Practice Address - Country:US
Practice Address - Phone:201-891-6100
Practice Address - Fax:201-891-7700
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-22
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225XE0001X, 225XH1200X, 225XL0004X, 225XN1300X, 225XP0019X
NY63014365225XP0200X
NY014365225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XE0001XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistEnvironmental Modification
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
No225XL0004XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistLow Vision
No225XN1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistNeurorehabilitation
No225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics