Individual
MR. EDWARD F IMMEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
1493 BLUE SPRUCE LN, WANTAGH, NY 11793-2528
(516) 456-8383
Mailing address
1493 BLUE SPRUCE LN, WANTAGH, NY 11793-2528
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
012849
NY
Other
Enumeration date
06/22/2010
Last updated
06/22/2010
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