Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 001201-1 | NY |
NPI | 1003055823 |
---|---|
Provider Name | Melanie G Ferguson |
First Address | New Windsor, NY 12553-7017 |
Second Address | New Windsor, NY 12553-7017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2009 |
Last Update Date | 18/02/2009 |