| NPI | 1609410216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA LARA Principal/Occupational Therapist 917-312-2252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist Pediatrics |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-11-06 |
| Last Update Date | 2019-11-06 |