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1821305681
JENNIFER LISTA
STATEN ISLAND, NY
NPI
1821305681
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225XP0200X Occupational Therapist, Pediatrics
(Licence: NY 015778-1)
Enumeration Date
2010-08-31
Last Update Date
2010-08-31
Business Address
-- JENNIFER LISTA
164 WOEHRLE AVE
STATEN ISLAND, NY 10312-1944
Phone number: 917-733-4919
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Mailing Address
-- JENNIFER LISTA
164 WOEHRLE AVE
STATEN ISLAND, NY 10312-1944
Phone number: 917-733-4919
Copy
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