Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | ||
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 008246 | NY |
NPI | 1285930990 |
---|---|
Provider Name | Ms. Eileen Leighton |
First Address | Ridge, NY 11961-2159 |
Second Address | Ridge, NY 11961-2159 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2011 |
Last Update Date | 28/01/2011 |