Individual
TINA MARIE VACCARELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
1800 EVERGREEN DR, CUTCHOGUE, NY 11935-1296
(631) 355-9066
Mailing address
1800 EVERGREEN DR, CUTCHOGUE, NY 11935-1296
(631) 355-9066
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0107881
NY
Other
Enumeration date
07/14/2010
Last updated
07/14/2010
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