Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 004853-1 | NY |
NPI | 1053756213 |
---|---|
Provider Name | Mrs. Roxanne Lisa Perry |
First Address | Armonk, NY 10504-1840 |
Second Address | Armonk, NY 10504-1840 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2013 |
Last Update Date | 01/05/2013 |