Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 019952 | NY |
NPI | 1003271958 |
---|---|
Provider Name | Claire Buckley |
First Address | New York, NY 10001-2505 |
Second Address | New York, NY 10001-2505 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2015 |
Last Update Date | 19/12/2015 |