Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 006861-1 | NY |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 006861-1 | NY |
NPI | 1841449519 |
---|---|
Provider Name | Susan J Olmstead |
First Address | Jamaica, NY 11435-1483 |
Second Address | Jamaica, NY 11435-1481 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2008 |
Last Update Date | 17/09/2008 |