Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 001703-1 | NY |
NPI | 1366742033 |
---|---|
Provider Name | Mrs. Arlene Goldberg |
First Address | Plainview, NY 11803 |
Second Address | Plainview, NY 11803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2010 |
Last Update Date | 28/10/2010 |