Provider Demographics
NPI:1366129405
Name:ARIAS, BERNARDO MUNOZ (OTA)
Entity type:Individual
Prefix:MR
First Name:BERNARDO
Middle Name:MUNOZ
Last Name:ARIAS
Suffix:
Gender:M
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9016 179TH PL
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432-5611
Mailing Address - Country:US
Mailing Address - Phone:917-963-6448
Mailing Address - Fax:
Practice Address - Street 1:9016 179TH PL
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11432-5611
Practice Address - Country:US
Practice Address - Phone:917-963-6448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008061-01224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Single Specialty