Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 006306-1 | NY |
NPI | 1003954363 |
---|---|
Provider Name | Ruth Santana |
First Address | Long Island City, NY 11106-3917 |
Second Address | Long Island City, NY 11106-3917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 08/07/2007 |