Individual
MR. SHELDON J TABACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS.OTR
Contact information
Practice address
90 BRYANT AVE APT 3BB, WHITE PLAINS, NY 10605-1934
(914) 772-4007
Mailing address
90 BRYANT AVE APT 3BB, WHITE PLAINS, NY 10605-1934
(914) 772-4007
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
001098-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001098-1
OCCUPATIONAL THERAPY
NY
Enumeration date
07/28/2010
Last updated
07/28/2010
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