Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 16166 | NY |
NPI | 1043521040 |
---|---|
Provider Name | Melissa Erin Putterman |
First Address | New York, NY 10065-7466 |
Second Address | New York, NY 10028-2972 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/06/2010 |
Last Update Date | 24/06/2010 |