Individual
PAN HE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2320 LINWOOD AVE APT 2A, FORT LEE, NJ 07024-3807
(917) 887-7002
Mailing address
246B LIVINGSTON ST UNIT 288, NORTHVALE, NJ 07647-1902
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
018478
NY
Other
Enumeration date
04/04/2023
Last updated
04/04/2023
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