Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 0225131 | NY |
NPI | 1003394826 |
---|---|
Provider Name | Laura Alexandra Stern |
First Address | Brooklyn, NY 11210-3735 |
Second Address | Brooklyn, NY 11230-6716 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2018 |
Last Update Date | 02/08/2018 |