Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 013601-1 | NY |
NPI | 1053466417 |
---|---|
Provider Name | Ms. Danielle Perugini |
First Address | Port Jefferson, NY 11777-1928 |
Second Address | Port Jefferson, NY 11777-1928 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2007 |
Last Update Date | 22/02/2009 |