Individual
MS. ELECTRA PETRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
5030 BROADWAY, SUITE 809, NEW YORK, NY 10034-1655
(212) 304-0400
Mailing address
2838 41ST ST, ASTORIA, NY 11103
(718) 726-5424
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
007803
NY
225XP0200X
Pediatric Occupational Therapist
Primary
007803
NY
Other
Enumeration date
09/24/2010
Last updated
09/24/2010
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