Provider Demographics
NPI:1124325949
Name:CANARIO, MARGARITA (COTA)
Entity type:Individual
Prefix:
First Name:MARGARITA
Middle Name:
Last Name:CANARIO
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97-30 QUEENS BLVD
Mailing Address - Street 2:REGO PARK
Mailing Address - City:QUEENS
Mailing Address - State:NY
Mailing Address - Zip Code:11374
Mailing Address - Country:US
Mailing Address - Phone:571-425-9150
Mailing Address - Fax:
Practice Address - Street 1:97-30 QUEENS BLVD
Practice Address - Street 2:REGO PARK
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:571-425-9150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY00205-5-1224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant