Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 008273-1 | NY |
NPI | 1023443504 |
---|---|
Provider Name | Ms. Kelly Bisignano |
First Address | Bronx, NY 10465-4139 |
Second Address | Bronx, NY 10465-4139 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2013 |
Last Update Date | 04/09/2013 |