Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 004459-1 | NY |
NPI | 1023339421 |
---|---|
Provider Name | Cheryl Kagen |
First Address | West Seneca, NY 14224-1928 |
Second Address | Buffalo, NY 14214-2152 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2010 |
Last Update Date | 20/06/2010 |