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Individual

MICHELE LYNN MANISOFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
4554 39TH PL, #4C, SUNNYSIDE, NY 11104-3571
(718) 729-6407
Mailing address
4554 39TH PL, #4C, SUNNYSIDE, NY 11104-3571
(718) 729-6407

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
007619
NY
225XP0200X
Pediatric Occupational Therapist
Primary
007619
NY

Other

Enumeration date
05/11/2010
Last updated
07/13/2010
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