Individual
MRS. MADELINE ELIZABETH PENALVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3 TRADER LN, BRENTWOOD, NY 11717-7510
(631) 650-4553
Mailing address
3 TRADER LN, BRENTWOOD, NY 11717-7510
(631) 650-4553
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
007558-1
NY
Other
Enumeration date
02/13/2008
Last updated
02/13/2008
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