Mara Gavrielova, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0221155 Issued in NY

Practice address

15327 88TH Ave
Jamaica, NY 11432-3831

Phone

(917) 747-9689

NPI assigned

Dec 26, 2017

Last updated

Dec 26, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mara Gavrielova Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1514246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514246400000",
    "number": "1508372657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10849 63RD AVE APT 3N",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751363",
            "telephone_number": "917-747-9689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15327 88TH AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114323831",
            "telephone_number": "917-747-9689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVRIELOVA",
        "first_name": "MARA",
        "name_prefix": "Miss",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-26",
        "last_updated": "2017-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "022115",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "0221155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARA",
            "last_name": "GAVRIELOVA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Madegine Gauthier
• Patricia Gauthier
• Yves Gauthier
• Rose Gautier
• Monica Gavilanes, LMSW
• Angelica Gavrilova, PA-C
• Diana Gavrilova, PA-C
• Svetlana Gavrilova, MD
• Maurice Antimano Gayatgay, P.T.
• Ariel Gayle

• Occupational Therapist in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2017; 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.