Individual
MS. MARYANN IJARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
8754 52ND AVE, ELMHURST, NY 11373-3938
(626) 512-7421
Mailing address
8754 52ND AVE, ELMHURST, NY 11373-3938
(626) 512-7421
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
020027-1
NY
Other
Enumeration date
03/01/2016
Last updated
03/01/2016
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