Individual
CARLA BAZAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
129A HILLSIDE AVE, WILLISTON PARK, NY 11596-2305
(516) 742-5243
Mailing address
59 ROSE LN, NEW HYDE PARK, NY 11040-1965
(516) 523-3166
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
12/05/2020
Last updated
12/05/2020
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