Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 004182-1 | NY |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 004182-1 | NY |
NPI | 1013162601 |
---|---|
Provider Name | Ms. Anne Elizabeth Peck-Davis |
First Address | Yorktown Hts, NY 10598-3337 |
Second Address | Granite Springs, NY 10598 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/11/2008 |
Last Update Date | 24/11/2008 |