Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 0057221 | NY |
NPI | 1053754317 |
---|---|
Provider Name | Amy Gail Lorino |
First Address | Forestburgh, NY 12777-6003 |
Second Address | Forestburgh, NY 12777-6003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2013 |
Last Update Date | 16/04/2013 |