Individual
CAROLYN N PERSRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
688 GAIL CT, ELMONT, NY 11003-4610
(516) 256-0727
Mailing address
688 GAIL CT, ELMONT, NY 11003-4610
(516) 256-0727
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
007665-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007665-1
OCCUPATIONAL THERAPIST
—
Enumeration date
03/08/2012
Last updated
03/08/2012
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