Provider Demographics
NPI:1528341419
Name:HACOHEN, MARCIA A (OTR)
Entity type:Individual
Prefix:MS
First Name:MARCIA
Middle Name:A
Last Name:HACOHEN
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 1:606 PONDSIDE DR
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10607-1367
Mailing Address - Country:US
Mailing Address - Phone:914-656-0710
Mailing Address - Fax:
Practice Address - Street 1:606 PONDSIDE DR
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10607-1367
Practice Address - Country:US
Practice Address - Phone:914-656-0710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-27
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3077-1225X00000X
225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY251300000XOtherTAXONOMY CODE
NY01395326OtherMAMARONECK SCHOOL DISTRICT NPI
NY01395326Medicaid