Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1093118630 |
---|---|
Provider Name | Nichole Sciremammano |
First Address | Geneva, NY 14456-1651 |
Second Address | Geneva, NY 14456-1651 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2014 |
Last Update Date | 26/09/2014 |