Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 440919 | NY |
NPI | 1023608148 |
---|---|
Provider Name | Miss Amy Azzari |
First Address | Katonah, NY 10536-3015 |
Second Address | Katonah, NY 10536-3015 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2021 |
Last Update Date | 22/01/2021 |