Provider Demographics
NPI:1063534360
Name:MAGLARAS, VASILIKI ELENI (OTR)
Entity type:Individual
Prefix:
First Name:VASILIKI
Middle Name:ELENI
Last Name:MAGLARAS
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 1:142 TOTOWA ROAD. APT. 11
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-1840
Mailing Address - Country:US
Mailing Address - Phone:973-508-6634
Mailing Address - Fax:
Practice Address - Street 1:25 5TH AVENUE
Practice Address - Street 2:
Practice Address - City:HASKELL
Practice Address - State:NJ
Practice Address - Zip Code:07420-1337
Practice Address - Country:US
Practice Address - Phone:973-839-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00379300225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist