Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 024372 | NY |
NPI | 1073145363 |
---|---|
Provider Name | Deepna Desai |
First Address | Forest Hills, NY 11375-4748 |
Second Address | Forest Hills, NY 11375-4748 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2020 |
Last Update Date | 05/02/2020 |