Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 007646-1 | NY |
N | 225XG0600X | Occupational Therapist - Gerontology | 46TR00569400 | NJ |
NPI | 1255705729 |
---|---|
Provider Name | Jan Sheerin |
First Address | Nyack, NY 10960-1649 |
Second Address | Nyack, NY 10960-1649 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2015 |
Last Update Date | 21/11/2015 |