Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 017294 | NY |
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 46TR00708500 | NJ |
NPI | 1396011896 |
---|---|
Provider Name | Miss Lyndsay Kathleen Mccusker |
First Address | East Rutherford, NJ 07073-1414 |
Second Address | Chatham, NJ 07928-1407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2012 |
Last Update Date | 29/06/2016 |