Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 015134-1 | NY |
NPI | 1053837146 |
---|---|
Provider Name | Sarah Siegel |
First Address | West Haverstraw, NY 10993 |
Second Address | West Haverstraw, NY 10993 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2017 |
Last Update Date | 16/06/2018 |