Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 010733-1 | NY |
NPI | 1043648587 |
---|---|
Provider Name | Rachel Lasar |
First Address | Staten Island, NY 10303-2204 |
Second Address | Staten Island, NY 10303-2204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2013 |
Last Update Date | 18/10/2013 |