Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 020466 | NY |
NPI | 1356797161 |
---|---|
Provider Name | Mrs. Kristina Mercedes Loftus |
First Address | Nanuet, NY 10954-5238 |
Second Address | Airmont, NY 10952-3420 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2016 |
Last Update Date | 22/06/2016 |