Provider Demographics
NPI:1902647902
Name:MARANTZ, ELEANOR (MS ED)
Entity type:Individual
Prefix:
First Name:ELEANOR
Middle Name:
Last Name:MARANTZ
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 NELSON AVE
Mailing Address - Street 2:
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2140
Mailing Address - Country:US
Mailing Address - Phone:917-402-1228
Mailing Address - Fax:
Practice Address - Street 1:122 NELSON AVE
Practice Address - Street 2:
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-2140
Practice Address - Country:US
Practice Address - Phone:917-402-1228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-04
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY365299222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist