Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 001528-1 | NY |
NPI | 1053566729 |
---|---|
Provider Name | Mrs. Laury Ellayne Garofano |
First Address | Pound Ridge, NY 10576-2323 |
Second Address | Pound Ridge, NY 10576-2323 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2008 |
Last Update Date | 23/11/2008 |