Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 015394 | NY |
NPI | 1003127978 |
---|---|
Provider Name | Princesita Conte |
First Address | Elmhurst, NY 11373-4825 |
Second Address | New York, NY 10007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2010 |
Last Update Date | 25/06/2010 |