Provider Demographics
NPI:1063121895
Name:MAGUIRE, OLIVIA RACHEL (PT, DPT)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:RACHEL
Last Name:MAGUIRE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 MAMARONECK AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-5224
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2000 CHAPEL VIEW BLVD STE 140
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-3087
Practice Address - Country:US
Practice Address - Phone:401-533-9616
Practice Address - Fax:401-533-9631
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT13788225100000X
RIPT03847225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist