Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 021331 | NY |
NPI | 1003357328 |
---|---|
Provider Name | Michelle Rose Mauro |
First Address | New York, NY 10009-3012 |
Second Address | New York, NY 10009-3012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2017 |
Last Update Date | 20/03/2017 |