Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 011988-1 | NY |
NPI | 1023375748 |
---|---|
Provider Name | Song Hui Rimassa |
First Address | Staten Island, NY 10314 |
Second Address | Staten Island, NY 10310-2635 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2012 |
Last Update Date | 19/04/2012 |