Individual
DANIEL MARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11411 145TH ST, JAMAICA, NY 11436-1140
(917) 825-2091
Mailing address
11411 145TH ST, JAMAICA, NY 11436-1140
(917) 825-2091
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
016435-1
NY
Other
Enumeration date
11/06/2016
Last updated
11/06/2016
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