Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 071256-1 | NY |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 017256-1 | NY |
N | 225XP0200X | Occupational Therapist - Pediatrics | 017256-1 | NY |
NPI | 1053671784 |
---|---|
Provider Name | Ms. Stephanie Scotto |
First Address | Staten Island, NY 10305-2611 |
Second Address | Staten Island, NY 10305-2611 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2012 |
Last Update Date | 29/05/2012 |