Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant |
NPI | 1023648482 |
---|---|
Provider Name | Hesain Ahmed |
First Address | Staten Island, NY 10310-2322 |
Second Address | Staten Island, NY 10310-2322 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2020 |
Last Update Date | 23/01/2020 |