Individual
KATIE SURDAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5 MALLARD DR, NEWBURGH, NY 12550-8769
(845) 476-1661
Mailing address
22 FLEETWOOD DR, WAPPINGERS FALLS, NY 12590-5317
(845) 590-2677
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007797-1
NY
Other
Enumeration date
11/02/2016
Last updated
11/02/2016
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