Individual
DINA BOUTEHSAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18910 RADNOR RD, HOLLIS, NY 11423-1021
(347) 268-8639
Mailing address
12017 84TH AVE, KEW GARDENS, NY 11415-3104
(917) 375-9887
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
029966
NY
Other
Enumeration date
03/05/2025
Last updated
03/05/2025
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