Individual
GRACE M ORTIZ-FATTIZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
105 SOUTH MADISON AVE, SPRING VALLEY, NY 10977
(845) 577-6058
Mailing address
41C HERITAGE DRIVE, NEW CITY, NY 10956
(845) 634-6376
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
004476-1
NY
Other
Enumeration date
09/26/2011
Last updated
09/26/2011
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