Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 000328-1 | NY |
NPI | 1669011623 |
---|---|
Provider Name | Barbara Ruth Fleischer |
First Address | Hawthorne, NY 10532-1732 |
Second Address | Hawthorne, NY 10532-1732 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2019 |
Last Update Date | 22/12/2019 |