Individual
SHAQUAN HERNRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
380 WASHINGTON AVE, ROOSEVELT, NY 11575-1845
(516) 378-2000
Mailing address
380 WASHINGTON AVE, ROOSEVELT, NY 11575-1845
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0066331
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0066331
—
NY
Enumeration date
02/25/2008
Last updated
02/25/2008
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