Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 011103-1 | NY |
NPI | 1912196106 |
---|---|
Provider Name | Mr. Yves-Marie Antoine |
First Address | Brooklyn, NY 11233-1804 |
Second Address | Brooklyn, NY 11233-1804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2007 |
Last Update Date | 24/10/2007 |