National Provider Identifier

Mary Angelina Mirabella, MS, OTR/L

Mary Angelina Mirabella, MS, OTR/L is listed in the NPPES registry with a primary specialty of Occupational Therapist in Ithaca, NY and a listed phone number of (607) 274-2102.

NPI 1497110613Ithaca, NYOccupational Therapist

Profile Overview

NPI
1497110613
Provider Type
Individual
Primary Specialty
Occupational Therapist
Enumeration Date
December 16, 2015
Last Updated
December 16, 2015

Practice Location

  • 400 Lake St
  • Ithaca, NY 14850-2132

Phone: (607) 274-2102

Specialties

  • Occupational Therapist (225X00000X)
Full Record
NPI
1497110613
Entity Type
Individual
Last Name
Mirabella
First Name
Mary
Middle Name
Angelina
Credential
MS, OTR/L
Mailing Street Address
400 Lake St
Mailing City
Ithaca
Mailing State
NY
Mailing ZIP Code
14850-2132
Mailing Country
US
Mailing Phone
(607) 274-2102
Practice Street Address
400 Lake St
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-2132
Practice Country
US
Practice Phone
(607) 274-2102
Enumeration Date
December 16, 2015
Last Updated
December 16, 2015
Sex
Female
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Occupational Therapist (225X00000X)
Other Identifiers
019910-1 (NY, Occupational Therapy State License)