Individual
FLEURETTE M FANFAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
11 PARK PL, VALLEY STREAM, NY 11580-3000
(212) 464-7958
Mailing address
11 PARK PL, VALLEY STREAM, NY 11580-3000
(212) 464-7958
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
012861
NY
Other
Enumeration date
01/18/2012
Last updated
01/18/2012
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