Individual
MS. GRACE PENTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
3500 SUNRISE HWY STE 111, GREAT RIVER, NY 11739-1001
(631) 650-6545
Mailing address
11 E JACKSON AVE, BABYLON, NY 11702-4208
(631) 827-2504
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
029847
NY
Other
Enumeration date
01/13/2025
Last updated
01/13/2025
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