Provider Demographics
| NPI: | 1245368463 |
|---|---|
| Name: | MARIANI, MATTHEW (OTR,BS) |
| Entity type: | Individual |
| Prefix: | MR |
| First Name: | MATTHEW |
| Middle Name: | |
| Last Name: | MARIANI |
| Suffix: | |
| Gender: | M |
| Credentials: | OTR,BS |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | 115 MAIN ST |
| Mailing Address - Street 2: | SUITE#202 2ND FLOOR |
| Mailing Address - City: | TUCKAHOE |
| Mailing Address - State: | NY |
| Mailing Address - Zip Code: | 10707-2948 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 914-961-1010 |
| Mailing Address - Fax: | 914-961-1011 |
| Practice Address - Street 1: | 115 MAIN ST |
| Practice Address - Street 2: | SUITE#202 |
| Practice Address - City: | TUCKAHOE |
| Practice Address - State: | NY |
| Practice Address - Zip Code: | 10707-2948 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 914-961-1010 |
| Practice Address - Fax: | 914-961-1011 |
| Is Sole Proprietor?: | No |
| Enumeration Date: | 2007-03-01 |
| Last Update Date: | 2023-10-20 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| NJ | 46TR01128100 | 225X00000X |
| NY | 0083021 | 225X00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| NY | 0401995 | Other | AETNA/ORTHONET TUCKAHOE |
| NY | 2343974 | Other | HUMANA |
| NY | 264524354 | Other | FPN MULTIPLAN/DME |
| NY | 272438120 | Other | HUDSON VALLEY HEALTH PLANS |
| NY | 02584178 | Medicaid | |
| NY | 1251 | Other | AMIDACARE-GROUP |
| NY | 1372776 | Other | CIGNA HEALTH PLANS-FACILITY |
| NY | 272438120 | Other | POMCO COMMERCIAL INSURANCE LINES |
| CT | 0401997 | Other | US FAMILY/ORTHONET MCLEAN AVENUE |
| NY | 10494309 | Other | CAQH |
| NY | 01828702 | Other | AMERIGROUP MEDICAID |
| NY | 0401997 | Other | AETNA/ORTHONET-MCLEAN AVENUE |
| NY | 1016396 | Other | NBCOT-NATIONAL BOARD CERTIFICATION OCCUPATIONAL THERAPY, INC |
| NY | 1245368463-01 | Other | HHC CHOICES GOLD HEALTH PLAN |
| NY | 201116700038 | Other | AFFINITY HEALTH PLAN |
| NY | 2343974 | Other | HUMANA DME |
| NY | 264524354 | Other | POMCO DME |
| NY | 786980 | Other | OPTUM HEATH PT-FACILITY |
| NY | 828451 | Other | OPTUM HEALTH PT/OXFORD HEALTH-CHILD/FREEDOM/FAMILY HEALTH/LIBERTY |
| NY | Q54981 | Other | EMPIRE BCBS |
| NY | 01828702 | Other | AMERIGROUP HEALTH PLAN(S) |
| NY | 0401995 | Other | CIGNA/ORHTONET- TUCKAHOE |
| NY | 0401997 | Other | CIGNA/ORTHONET-MCLEAN AVENUE |
| NY | 786980 | Other | UNITED HEALTHCARE PLANS FACILITY |
| NY | 272438120 | Other | FPN MULTIPLAN |
| NY | 272438120 | Other | MAGNACARE HEALTH PLANS LOCAL UNIONS IN NY STATE |
| NY | 272438120 | Other | AGEWELL OF NY |
| NY | 64519002 | Other | RAILROAD MEDICARE-DME |
| NY | 7056591 | Other | AETNA HEALTH PLAN LOCAL 1199 |
| NY | 0401995 | Other | US FAMILY/ORTHONET TUCKAHOE |
| NY | 272438129-001 | Other | HEALTHFIRST MEDICARE/COMPLETE MEDICARE/COMMERCIAL HEALTH PLANS |
| NY | 3017733 | Other | MVP HEALTH PLANS |
| NY | 0401997 | Other | CIGNA/ORTHONET-MCLEAN AVENUE |