Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 001764-1 | NY |
NPI | 1336459858 |
---|---|
Provider Name | Ms. Sharon Marie Gold |
First Address | Elizabethtown, NY 12932-0625 |
Second Address | Elizabethtown, NY 12932 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2010 |
Last Update Date | 18/10/2010 |