Provider Demographics
NPI:1194046466
Name:ACAYAN, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ACAYAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1554 UNIONPORT RD
Mailing Address - Street 2:APARTMENT 1D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-7819
Mailing Address - Country:US
Mailing Address - Phone:917-286-5147
Mailing Address - Fax:
Practice Address - Street 1:1554 UNIONPORT RD
Practice Address - Street 2:APARTMENT 1D
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-7819
Practice Address - Country:US
Practice Address - Phone:917-286-5147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014877-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist