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Individual

IFEANYI MATTHEW

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTA

Contact information

Practice address
1156 N BROADWAY, YONKERS, NY 10701-1108
(914) 965-3700
Mailing address
2838 BRUNER AVE, BRONX, NY 10469-3403
(718) 379-9820

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007024
NY

Other

Enumeration date
12/14/2011
Last updated
12/14/2011
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