Provider Demographics
NPI:1063720563
Name:RAFFEL, MARCEA BETH (OTR/L)
Entity type:Individual
Prefix:MS
First Name:MARCEA
Middle Name:BETH
Last Name:RAFFEL
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 1:320 E 65TH ST
Mailing Address - Street 2:#322
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6743
Mailing Address - Country:US
Mailing Address - Phone:212-737-5660
Mailing Address - Fax:212-737-5660
Practice Address - Street 1:320 E 65TH ST
Practice Address - Street 2:#322
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6743
Practice Address - Country:US
Practice Address - Phone:212-737-5660
Practice Address - Fax:212-737-5660
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004746-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist