Individual
MARY ANN VISCUSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
180 ALBANY AVE, LINDENHURST, NY 11757-2938
(631) 867-3250
Mailing address
1404 GOTHAM CT W, SAINT JAMES, NY 11780-3356
(631) 686-5280
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
004768
NY
Other
Enumeration date
09/10/2012
Last updated
09/10/2012
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