Individual
DEVORAH HERTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
91 HENDERSON AVE, STATEN ISLAND, NY 10301-2107
(516) 445-9042
Mailing address
21 BRIDGEWOOD AVE, LAKEWOOD, NJ 08701-4749
(516) 445-9042
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR00832000
NJ
Other
Enumeration date
10/09/2018
Last updated
10/09/2018
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