Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 018944-1 | NY |
NPI | 1003217803 |
---|---|
Provider Name | Racheal Ojo |
First Address | Staten Island, NY 10304-1943 |
Second Address | Staten Island, NY 10304-1943 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2014 |
Last Update Date | 11/09/2014 |