Individual
MR. DEEPAK THETTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 DEVONSHIRE CIR, PENFIELD, NY 14526-2665
(585) 314-4731
Mailing address
110 DEVONSHIRE CIR, PENFIELD, NY 14526-2665
(585) 314-4731
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
009482-1
NY
Other
Enumeration date
11/30/2011
Last updated
11/30/2011
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