Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 002777 | NY |
NPI | 1003044868 |
---|---|
Provider Name | Mrs. Vera A. Gallagher |
First Address | East Rockaway, NY 11518-1726 |
Second Address | East Rockaway, NY 11518-1530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2009 |
Last Update Date | 20/01/2012 |