Provider Demographics
NPI:1285447573
Name:MONAHAN, MARNIE ELIZABETH (MS, OTR/L)
Entity type:Individual
Prefix:
First Name:MARNIE
Middle Name:ELIZABETH
Last Name:MONAHAN
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 GARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11782-2622
Mailing Address - Country:US
Mailing Address - Phone:631-617-8488
Mailing Address - Fax:
Practice Address - Street 1:403 E 91ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-6800
Practice Address - Country:US
Practice Address - Phone:631-617-8488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-30
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028980-01225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist