Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 015880 | NY |
NPI | 1205131331 |
---|---|
Provider Name | Jee Yoon Chong |
First Address | Maspeth, NY 11378-1213 |
Second Address | Maspeth, NY 11378-1213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2011 |
Last Update Date | 12/09/2015 |