Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 003567 | NY |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 003567 | NY |
NPI | 1780767368 |
---|---|
Provider Name | Ms. Alice Margaret Dennis |
First Address | Bay Shore, NY 11706-6302 |
Second Address | Commack, NY 11725-2205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 08/07/2007 |