Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 012500-1 | NY |
NPI | 1003172511 |
---|---|
Provider Name | Mr. Kai-Shih Wang |
First Address | New York, NY 10011-2300 |
Second Address | New York, NY 10011-2300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2012 |
Last Update Date | 09/04/2012 |