Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 09271-1 | NY |
NPI | 1033363957 |
---|---|
Provider Name | Faye Dungca |
First Address | Flushing, NY 11358-3156 |
Second Address | Fresh Meadows, NY 11365-4105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2008 |
Last Update Date | 05/11/2008 |