Individual
KRIZIA MERCEDES GOWDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20 CEDAR ST, SUITE 302, NEW ROCHELLE, NY 10801-5247
(718) 949-0635
(718) 949-0635
Mailing address
259-24 147 RD, ROSEDALE, NY 11422
(718) 949-0635
(718) 949-0635
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
006542-1
NY
Other
Enumeration date
03/13/2012
Last updated
03/13/2012
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