NPI | 1154155109 |
---|---|
Entity Type | Organization |
Authorized Contact | KATHLEEN BRUSH Credentialing Manager 631-359-5805 |
Organization Subpart ? | No |
Primary Taxonomy | 225X00000X Occupational Therapist |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2024-08-30 |
Last Update Date | 2024-08-30 |