Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 004961-1 | NY |
NPI | 1003069626 |
---|---|
Provider Name | Patricia Marie Beraducci |
First Address | New York, NY 10023-6601 |
Second Address | New York, NY 10023-6601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2008 |
Last Update Date | 28/10/2008 |