Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation |
NPI | 1366085029 |
---|---|
Provider Name | Ramy S Azer |
First Address | Staten Island, NY 10308-2627 |
Second Address | Brooklyn, NY 11235-1604 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2019 |
Last Update Date | 24/10/2019 |