Individual
ELLEN MODLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
55 BLUE BIRD DR, GREAT NECK, NY 11023-1001
(917) 771-4932
Mailing address
55 BLUE BIRD DR, GREAT NECK, NY 11023-1001
(917) 771-4932
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
007537
NY
Other
Enumeration date
11/03/2008
Last updated
11/03/2008
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