Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 015415 | NY |
NPI | 1336406495 |
---|---|
Provider Name | Lauren E Hanly |
First Address | Seaford, NY 11783-3450 |
Second Address | Seaford, NY 11783-3450 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2012 |
Last Update Date | 13/04/2012 |