Individual
URSULA E ALEXIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
5354 65TH PL FL 2, MASPETH, NY 11378-1654
(631) 796-2163
Mailing address
53-54 65TH PLACE 2ND FLOOR, MASPETH, NY 11378-1654
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0074391
NY
Other
Enumeration date
04/25/2012
Last updated
04/25/2012
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