Individual
AMANDA PERALTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3126 43RD ST, ASTORIA, NY 11103-2702
(646) 719-6090
Mailing address
3126 43RD ST, ASTORIA, NY 11103-2702
(646) 719-6090
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
010810
NY
Other
Enumeration date
06/27/2021
Last updated
12/10/2024
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