Individual
CHRISTIAN BANTIGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
107 NORTHERN BLVD STE 308, GREAT NECK, NY 11021-4309
(516) 504-4263
Mailing address
6945 108TH ST APT 9E, FOREST HILLS, NY 11375-3836
(201) 742-2836
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
09/11/2019
Last updated
09/11/2019
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