Individual
MARIA CHARISSE JUDILLA GASTADOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5009 38TH ST, 3F, LONG ISLAND CITY, NY 11101-1901
(917) 774-0968
Mailing address
5009 38TH ST, 3F, LONG ISLAND CITY, NY 11101-1901
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
013827-1
NY
Other
Enumeration date
06/23/2010
Last updated
02/28/2011
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