Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 006763-1 | NY |
NPI | 1013249267 |
---|---|
Provider Name | Shiri Aviva Cohen |
First Address | Staten Island, NY 10314-6336 |
Second Address | Staten Island, NY 10314-6336 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2010 |
Last Update Date | 12/02/2010 |