Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 0045061 | NY |
NPI | 1023326493 |
---|---|
Provider Name | Mrs. Marcia A Lewis |
First Address | Nanuet, NY 10954-5959 |
Second Address | Nanuet, NY 10954-5959 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2010 |
Last Update Date | 20/09/2010 |