Individual
DAURIS DE JESUS TAVAREZ MARTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
20 LENOX AVE APT 2Q, NEW YORK, NY 10026-3822
(917) 741-0252
Mailing address
20 LENOX AVE APT 2Q, NEW YORK, NY 10026-3822
(917) 741-0252
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
022820
NY
Other
Enumeration date
09/12/2018
Last updated
12/31/2019
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