Individual
AIYANA AMARIS MATONDO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
105 STEVENS AVENUE, MOUNT VERNON, NY 10550
(914) 668-4238
Mailing address
15 HUDSON AVENUE, MOUNT VERNON, NY 10553
(201) 566-6429
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
009716-1
NY
Other
Enumeration date
10/29/2019
Last updated
10/29/2019
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