Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 009457 | NY |
NPI | 1023590726 |
---|---|
Provider Name | Blaire S Lifschutz |
First Address | Hewlett, NY 11557-1651 |
Second Address | Hartsdale, NY 10530-1952 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2018 |
Last Update Date | 30/08/2018 |