Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 010353 | NY |
Y | 225XM0800X | Mental Health | 0110353 | NY |
NPI | 1912305285 |
---|---|
Provider Name | Mr. Henry Hanif |
First Address | Queens Village, NY 11427-1217 |
Second Address | Queens Village, NY 11427-1217 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2014 |
Last Update Date | 18/12/2014 |