Individual
MR. STANLEY P DESGROSEILLIERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTA
Contact information
Practice address
74 TIER ST, BRONX, NY 10464-1342
(718) 885-1312
Mailing address
74 TIER ST, BRONX, NY 10464-1342
(718) 885-1312
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007541
NY
Other
Enumeration date
07/18/2010
Last updated
07/18/2010
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