Individual
SUSAN PENDERGAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
28 TEPHANIC AVE, MONROE, NY 10950-1418
(845) 783-1223
Mailing address
28 TEPHANIC AVE, MONROE, NY 10950-1418
(845) 783-1223
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
003749-1
NY
Other
Enumeration date
08/06/2008
Last updated
08/06/2008
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