Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 009550-1 | NY |
NPI | 1063665818 |
---|---|
Provider Name | Christine D Rogan |
First Address | Bayside, NY 11360-2810 |
Second Address | Bayside, NY 11360-2810 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2008 |
Last Update Date | 18/02/2014 |