Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 010779-1 | NY |
NPI | 1003125436 |
---|---|
Provider Name | Sara E Inserra |
First Address | Stony Brook, NY 11790-2120 |
Second Address | Stony Brook, NY 11790-2120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2010 |
Last Update Date | 21/12/2011 |