Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | ||
Y | 225X00000X | Occupational Therapist | 400640 | NY |
N | 225X00000X | Occupational Therapist | 46TR00827000 | NJ |
NPI | 1003376286 |
---|---|
Provider Name | Stephanie Powers Pitta |
First Address | Westfield, NJ 07090-4348 |
Second Address | Staten Island, NY 10305-3436 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2019 |
Last Update Date | 22/03/2019 |