Provider Demographics
NPI:1306113626
Name:TSVETKOV, MARIA (OTR)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:TSVETKOV
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 GREEN ST
Mailing Address - Street 2:ELDER SERVICE PROGRAM
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3312
Mailing Address - Country:US
Mailing Address - Phone:617-575-5842
Mailing Address - Fax:
Practice Address - Street 1:270 GREEN ST
Practice Address - Street 2:ELDER SERVICE PROGRAM
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3312
Practice Address - Country:US
Practice Address - Phone:617-575-5842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10425225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
283177OtherNBCOT (NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY)
MA10425OtherCOMMONWEALTH OF MASSACHUSETTS DIVISION OF PROFESSIONAL LICENSURE