Individual
RICCARDO ANTHONY GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
1590 E 95TH ST, BROOKLYN, NY 11236-5414
(347) 351-5055
Mailing address
1590 E 95TH ST, BROOKLYN, NY 11236-5414
(347) 351-5055
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
009028
—
Other
Enumeration date
03/20/2022
Last updated
03/20/2022
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