Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 026146 | NY |
NPI | 1053075366 |
---|---|
Provider Name | Gwendalyn Amabile Neuman |
First Address | Lockport, NY 14094-3519 |
Second Address | Kenmore, NY 14217-1040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2021 |
Last Update Date | 25/10/2021 |