Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 012193 | NY |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | ||
N | 225XP0200X | Occupational Therapist - Pediatrics | 012193 | NY |
NPI | 1699955567 |
---|---|
Provider Name | Dominic Joseph D'orazio |
First Address | Massapequa, NY 11758-2501 |
Second Address | Massapequa, NY 11758-2501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2007 |
Last Update Date | 05/12/2007 |