Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XG0600X | Occupational Therapist - Gerontology | 06999-1 | NY |
NPI | 1881175040 |
---|---|
Provider Name | Mr. Paul Graupman |
First Address | Spencerport, NY 14559-2041 |
Second Address | Greece, NY 14612-2312 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2018 |
Last Update Date | 27/08/2018 |