Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 008183-1 | NY |
NPI | 1013162940 |
---|---|
Provider Name | Mr. Rubin L Shirodkar |
First Address | Plainview, NY 11803-3409 |
Second Address | Plainview, NY 11803-3409 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/11/2008 |
Last Update Date | 19/11/2008 |