Individual
FEDNOR JEAN-LOUIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
4018 68TH ST, WOODSIDE, NY 11377-3892
(845) 659-9898
Mailing address
4018 68TH ST, WOODSIDE, NY 11377-3892
(845) 659-9898
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007529-1
NY
Other
Enumeration date
07/17/2020
Last updated
07/17/2020
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