Individual
MS. MICHAL BEN-BARUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
475 W 250TH ST, BRONX, NY 10471-2925
(718) 549-4753
Mailing address
650 PARK AVE, ELIZABETH, NJ 07208-1351
(908) 875-3343
Taxonomy
Speciality
Code
Description
License number
State
224ZE0001X
Environmental Modification Occupational Therapy Assistant
—
—
225X00000X
Occupational Therapist
P10219
NY
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112549097
—
NJ
Enumeration date
05/09/2018
Last updated
07/20/2018
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