Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 63015738 | NY |
NPI | 1013229194 |
---|---|
Provider Name | Gila Rosenbaum |
First Address | Staten Island, NY 10314-4328 |
Second Address | Staten Island, NY 10305-3436 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2010 |
Last Update Date | 06/07/2010 |