| NPI | 1982062113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINA KIMACHENKO Billing Manager 718-395-3155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: NY 019788-1) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NJ 46tr00702800) |
| 225X00000X Occupational Therapist (Licence: NY 019703) | |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2017-02-02 |