Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 000166 | NY |
NPI | 1003907254 |
---|---|
Provider Name | Ms. Christine Cantine Lighthipe |
First Address | Syracuse, NY 13210-2306 |
Second Address | Syracuse, NY 13210-2306 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 08/07/2007 |