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Individual

LANI WEYMOUTH EVON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA

Contact information

Practice address
2327 24TH ST, ASTORIA, NY 11105-3414
(917) 439-9916
Mailing address
2327 24TH ST, ASTORIA, NY 11105-3414
(718) 932-7816

Taxonomy

Speciality
Code
Description
License number
State
273Y00000X
Rehabilitation Hospital Unit
Primary
006541-1
NY

Other

Enumeration date
09/29/2006
Last updated
12/14/2011
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