| NPI | 1053173062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN BRUSH Manager Of Credentialing 631-359-5805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2024-01-25 |
| Last Update Date | 2024-10-29 |