Individual
GLENDA CORPUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTA
Contact information
Practice address
176 KEARNEY AVE, BRONX, NY 10465-3421
(630) 788-9694
Mailing address
176 KEARNEY AVE, BRONX, NY 10465-3421
(630) 788-9694
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007747-1
NY
Other
Enumeration date
11/15/2023
Last updated
11/15/2023
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