Individual
MR. RAHULDEB MUKERJI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTA
Contact information
Practice address
17022 90TH AVE, JAMAICA, NY 11432-5430
(917) 403-8211
Mailing address
17022 90TH AVE, JAMAICA, NY 11432-5430
(917) 403-8211
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
008006
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008006
NYS OTA LICENSE
NY
Enumeration date
02/13/2013
Last updated
02/13/2013
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