Provider Demographics
NPI:1881274124
Name:MONAHAN, VIRGINIA LINN (MOT, ORT/L)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:LINN
Last Name:MONAHAN
Suffix:
Gender:F
Credentials:MOT, ORT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1377 MOTOR PKWY STE 307
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-5258
Mailing Address - Country:US
Mailing Address - Phone:914-294-4050
Mailing Address - Fax:631-760-8306
Practice Address - Street 1:1009 CENTERBROOKE LN STE 103
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-8664
Practice Address - Country:US
Practice Address - Phone:757-744-5600
Practice Address - Fax:757-216-1141
Is Sole Proprietor?:No
Enumeration Date:2021-04-12
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119009034225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist