Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 014401-1 | NY |
NPI | 1013396910 |
---|---|
Provider Name | Pooa Bloomberg |
First Address | Ossining, NY 10562-1965 |
Second Address | Valhalla, NY 10595-1503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/05/2015 |
Last Update Date | 26/05/2015 |