Individual
JARED VICTOR VIRELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
49 MONTROSE AVE, BROOKLYN, NY 11206-2580
(718) 473-3808
Mailing address
511 W 232ND ST APT E43, BRONX, NY 10463-3561
(646) 221-8750
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
011108
NY
Other
Enumeration date
05/31/2022
Last updated
05/31/2022
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