Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 007993-1 | NY |
NPI | 1336473727 |
---|---|
Provider Name | Ruth Van Leeuwen |
First Address | New York, NY 10038-4812 |
Second Address | New York, NY 10038-4812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2009 |
Last Update Date | 10/12/2012 |