Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 011697 | NY |
NPI | 1043455991 |
---|---|
Provider Name | Marianna Reluzco |
First Address | Oceanside, NY 11572-2433 |
Second Address | Oceanside, NY 11572-2433 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2008 |
Last Update Date | 06/12/2008 |