Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 018716-1 | NY |
NPI | 1003233297 |
---|---|
Provider Name | Michele Rostowsky |
First Address | New York, NY 10012-2630 |
Second Address | New York, NY 10012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2014 |
Last Update Date | 16/11/2015 |