Provider Demographics
NPI:1528280567
Name:BUO, MARIA ELAINE C (OTR)
Entity type:Individual
Prefix:
First Name:MARIA ELAINE
Middle Name:C
Last Name:BUO
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 1:3044 WALLACE AVE
Mailing Address - Street 2:APT 3A
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-8475
Mailing Address - Country:US
Mailing Address - Phone:646-236-3543
Mailing Address - Fax:
Practice Address - Street 1:460 WEST 34TH STREET
Practice Address - Street 2:11TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001
Practice Address - Country:US
Practice Address - Phone:212-273-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY014423OtherLICENSE