Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 007-046-1 | NY |
NPI | 1003190786 |
---|---|
Provider Name | Mary Carolan-Murphy |
First Address | Bellerose Village, NY 11001-4007 |
Second Address | Floral Park, NY 11001-2911 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2011 |
Last Update Date | 29/09/2011 |