Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1245846120 |
---|---|
Provider Name | Jordan Trinagel |
First Address | New York, NY 10028-3041 |
Second Address | Brooklyn, NY 11206-2580 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2020 |
Last Update Date | 16/09/2020 |