Provider Demographics
NPI:1285053736
Name:MUIA, JENNIFER (OTR/L)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:MUIA
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 1:87 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10992-1279
Mailing Address - Country:US
Mailing Address - Phone:845-678-3562
Mailing Address - Fax:845-614-5465
Practice Address - Street 1:59 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:WINGDALE
Practice Address - State:NY
Practice Address - Zip Code:12594-1461
Practice Address - Country:US
Practice Address - Phone:845-234-3969
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008643-1225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics