Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 003860-1 | NY |
NPI | 1073823613 |
---|---|
Provider Name | Laura Armenia Fumerelle |
First Address | Buffalo, NY 14214-2349 |
Second Address | Buffalo, NY 14214-2349 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2010 |
Last Update Date | 18/10/2010 |