Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 011695-1 | NY |
NPI | 1073766127 |
---|---|
Provider Name | Ms. Kerry Patten |
First Address | Bellmore, NY 11710-3532 |
Second Address | Plainview, NY 11803-4725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/11/2008 |
Last Update Date | 02/11/2008 |