Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | 004989 | NY |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 004989 | NY |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 004989 | NY |
NPI | 1710130869 |
---|---|
Provider Name | Mrs. Suzie Dorsainvil |
First Address | Valley Stream, NY 11580-1925 |
Second Address | Valley Stream, NY 11580-1925 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2008 |
Last Update Date | 01/11/2008 |