Individual
DANA TOWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
210 N CENTRAL AVE STE 330, HARTSDALE, NY 10530-1951
(914) 946-5685
Mailing address
576 BROADHOLLOW RD, MELVILLE, NY 11747-5002
(631) 359-5859
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
018802
NY
Other
Enumeration date
04/24/2014
Last updated
01/16/2020
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