Individual
MISS JANUARY MAGNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
8634 89TH ST # 2RE, WOODHAVEN, NY 11421-1326
(917) 270-1055
Mailing address
8634 89TH ST # 2RE, WOODHAVEN, NY 11421-1326
(917) 270-1055
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0148251
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053612945
—
NY
Enumeration date
08/29/2011
Last updated
08/29/2011
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