Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 022757-1 | NY |
NPI | 1013499292 |
---|---|
Provider Name | Miss Angela Ann Buscemi |
First Address | Plainview, NY 11803-1219 |
Second Address | Ronkonkoma, NY 11779-7360 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2018 |
Last Update Date | 04/09/2018 |