Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 004971-1 | NY |
NPI | 1033343363 |
---|---|
Provider Name | Mr. Erwin R Martus |
First Address | Brooklyn, NY 11236-5521 |
Second Address | Brooklyn, NY 11236-5521 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/05/2009 |
Last Update Date | 14/05/2009 |