Provider Demographics
NPI:1083508543
Name:MACZKO, MEAGHAN ELISABETH (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:MEAGHAN
Middle Name:ELISABETH
Last Name:MACZKO
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:MEAGHAN
Other - Middle Name:ELISABETH
Other - Last Name:LAWRENCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:31 WALTER ST
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02889-1321
Mailing Address - Country:US
Mailing Address - Phone:401-714-9169
Mailing Address - Fax:
Practice Address - Street 1:1 OFFICE PKWY
Practice Address - Street 2:
Practice Address - City:EAST PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02914-1643
Practice Address - Country:US
Practice Address - Phone:508-203-6004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIOT02369225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist