Marisa Bonventre, OTR
Individual provider Active NPI Occupational Therapist · Islip, NY
NPI 1366089476 · NPPES record last updated Dec 9, 2019
Key facts
- NPI
- 1366089476
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 024272-01 (NY)
- Practice address
- 252 Islip Ave
Islip, NY 11751-3015 - Phone
- (631) 581-6800
- NPI assigned
- Dec 9, 2019
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 024272-01 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kids in Action | Past |
Accepting new patients | |
| Kids in Action of L.I. Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 024272-01 | NY | Yes |
Addresses
Primary practice location
252 Islip Ave
Islip, NY 11751-3015
Mailing address
107 Wartburg Ave Apt 109
Copiague, NY 11726-2941
Phone (631) 374-2192
Other providers in Islip, NY
- Lauren Betz
- Prashant Bhenswala
- Lily Alessandra Bilello
- Chelsea Rae Bjornsson
- Delores Bocklet
- Georgiana Borda
- Tracey Maria Boriel
- Robert Anthony Bottner
- Christina Bozza
- Jaclynn Brandi
All providers in Islip, NY · Occupational Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.