Provider Demographics
NPI:1588950109
Name:OKONIEWSKI, RITA MORAN (OTR)
Entity type:Individual
Prefix:MS
First Name:RITA
Middle Name:MORAN
Last Name:OKONIEWSKI
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:PO BOX 468
Mailing Address - Street 2:
Mailing Address - City:VOORHEESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12186-0468
Mailing Address - Country:US
Mailing Address - Phone:518-765-2382
Mailing Address - Fax:518-765-3842
Practice Address - Street 1:129 MAPLE AVE
Practice Address - Street 2:
Practice Address - City:VOORHEESVILLE
Practice Address - State:NY
Practice Address - Zip Code:12186-9726
Practice Address - Country:US
Practice Address - Phone:518-765-2382
Practice Address - Fax:518-765-3842
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001055-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist