Individual
BENSON LARRI GEROY TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8439 56TH AVE APT 2, ELMHURST, NY 11373-4969
(347) 834-1384
Mailing address
8439 56TH AVE APT 2, ELMHURST, NY 11373-4969
(347) 834-1384
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
011378
NY
Other
Enumeration date
07/27/2023
Last updated
07/27/2023
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