Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 002849-1 | NY |
NPI | 1215261573 |
---|---|
Provider Name | Mr. William Michel |
First Address | North Bellmore, NY 11710-1317 |
Second Address | North Bellmore, NY 11710-1317 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2009 |
Last Update Date | 18/09/2009 |