Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225CA2400X | Assistive Technology Practitioner |
NPI | 1023374725 |
---|---|
Provider Name | Adam Krass |
First Address | Rutherford, NJ 07070-1105 |
Second Address | Rutherford, NJ 07070-1105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2012 |
Last Update Date | 06/04/2012 |