Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 011824-1 | NY |
NPI | 1023261179 |
---|---|
Provider Name | Ms. Jamie Marie Martineau |
First Address | New Hartford, NY 13413-2029 |
Second Address | New Hartford, NY 13413-2029 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2008 |
Last Update Date | 01/11/2008 |