Provider Demographics
NPI:1194978858
Name:TERRANOVA, MARIE ELIZABETH (OTR/L)
Entity type:Individual
Prefix:MS
First Name:MARIE
Middle Name:ELIZABETH
Last Name:TERRANOVA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:MARIE
Other - Middle Name:ELIZABETH
Other - Last Name:SICA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1015 WINDERMERE ROAD
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN SQUARE
Mailing Address - State:NY
Mailing Address - Zip Code:11010
Mailing Address - Country:US
Mailing Address - Phone:516-872-8838
Mailing Address - Fax:
Practice Address - Street 1:1015 WINDERMERE RD
Practice Address - Street 2:
Practice Address - City:FRANKLIN SQUARE
Practice Address - State:NY
Practice Address - Zip Code:11010-1742
Practice Address - Country:US
Practice Address - Phone:516-872-8838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2757225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist