Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mrs. Mary Mai Iwanenko, MS, OTR/L, ATP, SI/C

Individual provider Specialist · NPI 1811173990

Mrs. Mary Mai Iwanenko, MS, OTR/L, ATP, SI/C is a Specialist in Lackawanna, New York. Licensed in New York. Registered with an NPI since 2008.

Licensed in
NY
In the registry since
2008
What do these letters mean?
MS — Master of Science
A graduate science degree.
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

1025 Ridge Rd
Lackawanna, NY 14218-1755
Phone: (716) 822-4781
Fax: (716) 362-8989
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 006633-1 (NY)

Record details

NPI number1811173990
Entity typeIndividual (Type 1)
GenderFemale
Credentials MS , OTR/L , ATP , SI/C
Sole proprietorNo
NPI enumeratedJanuary 18, 2008
Last updated in NPPESJanuary 18, 2008

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