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LEGENDARY THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTINE SALOMON MA, OTR/L (CLINICAL SUPERVISOR)
(917) 853-1226
Entity
Organization

Contact information

Practice address
997 STAFFORD AVE, STATEN ISLAND, NY 10309-2109
(917) 853-1226
(718) 679-9823
Mailing address
997 STAFFORD AVE, STATEN ISLAND, NY 10309-2109
(917) 853-1226
(718) 679-9823

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary

Other

Enumeration date
04/30/2013
Last updated
04/30/2013
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