| NPI | 1508505884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN BRUSH Credentialing Coordinator Manager 631-359-5805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Enumeration Date | 2022-06-03 |
| Last Update Date | 2022-06-03 |