Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 3365-1 | NY |
NPI | 1023414091 |
---|---|
Provider Name | Abbey Brod Rosen |
First Address | New York, NY 10075-0264 |
Second Address | New York, NY 10075-0264 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2014 |
Last Update Date | 18/11/2014 |