Individual
NICOLE BENVENUTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
561 ROUTE 9W, PIERMONT, NY 10968-1116
(845) 680-1400
Mailing address
15 NEWFIELD RD, HEWITT, NJ 07421-1534
(973) 229-5987
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
010985
NY
Other
Enumeration date
12/09/2021
Last updated
12/09/2021
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