Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 023797-01 | NY |
N | 225X00000X | Occupational Therapist | 101045-01 | NY |
NPI | 1003477340 |
---|---|
Provider Name | Caila Jeanne Grabek |
First Address | Cheektowaga, NY 14225-2149 |
Second Address | Cheektowaga, NY 14225-1851 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2019 |
Last Update Date | 20/08/2019 |