Individual provider Active NPI

Mariel Vaknin, OTR/L

  • Pediatric Occupational Therapist
  • Staten Island, NY
National Provider Identifier
1194263806
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
021210-1 Issued in NY
Practice address
1550 Forest Hill Rd
Staten Island, NY 10314-6336
Phone
(347) 461-1860
NPI assigned
Feb 2, 2017
Last updated
Mar 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 021210-1 NY Primary

Addresses

Primary practice location

1550 Forest Hill Rd
Staten Island, NY 10314-6336

Mailing address

1550 Forest Hill Rd
Staten Island, NY 10314-6336
Phone (347) 461-1860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
021210-1NYMDPediatric Occupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1194263806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 FOREST HILL RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146336",
            "telephone_number": "347-461-1860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 FOREST HILL RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146336",
            "telephone_number": "347-461-1860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAKNIN",
        "first_name": "MARIEL",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-02",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "021210-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.