Individual
AISELA ULI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
5 RAVENSWOOD CT, WEST NYACK, NY 10994-1013
(917) 992-1097
Mailing address
5 RAVENSWOOD CT, WEST NYACK, NY 10994-1013
(917) 992-1097
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
016686
NY
Other
Enumeration date
05/20/2012
Last updated
05/20/2012
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