Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 13253 | NY |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 13253 | NY |
NPI | 1730209008 |
---|---|
Provider Name | Mrs. Jill Dennisperez |
First Address | New York, NY 10021-5647 |
Second Address | New York, NY 10021-4870 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2007 |
Last Update Date | 08/07/2007 |