Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 008322-1 | NY |
NPI | 1285711622 |
---|---|
Provider Name | Blanche Leeman |
First Address | Hampton Bays, NY 11946-1993 |
Second Address | Hampton Bays, NY 11946-1993 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |