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Individual

WILLIAM L JIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
139 CENTRE ST STE 814, NEW YORK, NY 10013
(212) 966-1288
Mailing address
7712 KNEELAND AVE, ELMHURST, NY 11373-4102

Taxonomy

Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
021803-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
05103177
NY
Enumeration date
09/21/2017
Last updated
08/28/2018
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