Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 009834-01 | NY |
NPI | 1316552235 |
---|---|
Provider Name | Ms. Anupama Kukade |
First Address | Old Bridge, NJ 08857-3050 |
Second Address | Old Bridge, NJ 08857-3050 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2020 |
Last Update Date | 09/09/2020 |