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Individual

MR. HERNAN AYALA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
5821 84TH ST, MIDDLE VILLAGE, NY 11379-5418
(718) 476-9092
Mailing address
5821 84TH ST, MIDDLE VILLAGE, NY 11379-5418
(718) 476-9092

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
NY

Other

Enumeration date
10/09/2007
Last updated
10/09/2007
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