Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 005645 | NY |
NPI | 1124311428 |
---|---|
Provider Name | Mrs. Sharon Sedlak |
First Address | Kingston, NY 12401-3705 |
Second Address | Kingston, NY 12401-3705 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2011 |
Last Update Date | 18/05/2011 |