Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 005728-1 | NY |
NPI | 1073823423 |
---|---|
Provider Name | Joyce Berliner |
First Address | Corning, NY 14830 |
Second Address | Corning, NY 14830 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2010 |
Last Update Date | 19/10/2010 |