Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 004675-1 | NY |
NPI | 1003190307 |
---|---|
Provider Name | Mrs. Vicki Lee Ramie-Tripido |
First Address | Liberty, NY 12754-2117 |
Second Address | Liberty, NY 12754-2117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2011 |
Last Update Date | 05/10/2011 |