Provider Demographics
NPI:1053789479
Name:MORALES, JULINNIS (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:JULINNIS
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MS
Other - First Name:JULINNIS
Other - Middle Name:
Other - Last Name:PENA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:47 GILMORE DR.
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980
Mailing Address - Country:US
Mailing Address - Phone:845-729-0214
Mailing Address - Fax:
Practice Address - Street 1:72 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10552
Practice Address - Country:US
Practice Address - Phone:845-729-0214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-02
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00641900225XG0600X
NY018559225XP0200X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics