Provider Demographics
NPI:1285939132
Name:PALOP MAYA, KRISTINA (OTR/L)
Entity type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:
Last Name:PALOP MAYA
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 1:163 TWEED BLVD
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960-4913
Mailing Address - Country:US
Mailing Address - Phone:646-207-2725
Mailing Address - Fax:
Practice Address - Street 1:163 TWEED BLVD
Practice Address - Street 2:
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-4913
Practice Address - Country:US
Practice Address - Phone:646-207-2725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-24
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016076-1172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker