Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 2133 | NY |
NPI | 1942582374 |
---|---|
Provider Name | Pamela Colangelo |
First Address | Syracuse, NY 13215-2265 |
Second Address | Syracuse, NY 13215-2265 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2011 |
Last Update Date | 12/09/2011 |