Individual
RITA MAE TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
11515 101ST AVE, SOUTH RICHMOND HILL, NY 11419-1247
(718) 441-5333
Mailing address
11203 111TH AVE, SOUTH OZONE PARK, NY 11420-1118
(718) 738-0475
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
008595-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008595-1
NYS LICENSE NUMBER
NY
Enumeration date
09/29/2010
Last updated
09/29/2010
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