Individual
MADELINE MORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1424 SHAKESPEARE AVE, APT# 2FL, BRONX, NY 10452
(347) 262-0850
Mailing address
1424 SHAKESPEARE AVE, APT# 2FL, BRONX, NY 10452
(347) 262-0850
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
009301
NY
Other
Enumeration date
05/12/2017
Last updated
05/12/2017
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