Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 46TR00005900 | NJ |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 46TR00005900 | NJ |
NPI | 1023197811 |
---|---|
Provider Name | Mrs. Linda Michelle Sragow |
First Address | Teaneck, NJ 07666-2821 |
Second Address | Teaneck, NJ 07666-2821 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2006 |
Last Update Date | 03/11/2017 |