Individual
MR. JUAN R JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
75-59 263 STREET, GLEN OAKS, NY 11421
(718) 470-8580
Mailing address
91-48 88TH ROAD, APT 5A, WOODHAVEN, NY 11421
(718) 470-8580
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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