Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 019315 | NY |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 019315 | NY |
NPI | 1134527278 |
---|---|
Provider Name | Stephelenecie Calixte |
First Address | Brooklyn, NY 11226-2183 |
Second Address | Brooklyn, NY 11230-5849 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2014 |
Last Update Date | 05/12/2014 |