Individual
MR. JOHN THOMAS SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, OTR
Contact information
Practice address
6222 WEST 168 STREET, NEW YORK, NY 10032
(212) 305-7674
Mailing address
120 WEST 80 STREET #3R, NEW YORK, NY 10024
(917) 453-5016
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
005708
NY
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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