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1962648568
KEITH M VAN TASSELL
STATEN ISLAND, NY
NPI
1962648568
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225XP0200X Occupational Therapist, Pediatrics
(Licence: NY 010331-1)
Enumeration Date
2009-01-02
Last Update Date
2009-01-02
Business Address
-- KEITH M VAN TASSELL OTR/L
243 DEMOREST AVE
STATEN ISLAND, NY 10314-3160
Phone number: 718-447-1414
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Mailing Address
-- KEITH M VAN TASSELL OTR/L
243 DEMOREST AVE
STATEN ISLAND, NY 10314-3160
Phone number: 718-447-1414
Copy
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