Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 002501-1 | NY |
NPI | 1023241163 |
---|---|
Provider Name | Eileen Sanford |
First Address | Amsterdam, NY 12010-6001 |
Second Address | Amsterdam, NY 12010-6001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2009 |
Last Update Date | 24/08/2009 |