Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 019892 | NY |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 019892 | NY |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 019892 | NY |
N | 225XP0200X | Occupational Therapist - Pediatrics | 019892 | NY |
NPI | 1477008142 |
---|---|
Provider Name | Lindsay Rose Heneage |
First Address | Brooklyn, NY 11201-6737 |
Second Address | Brooklyn, NY 11216-1609 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2016 |
Last Update Date | 20/12/2016 |