Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 022562 | NY |
NPI | 1023579414 |
---|---|
Provider Name | Talia Arabov |
First Address | Fresh Meadows, NY 11366-1610 |
Second Address | Fresh Meadows, NY 11366-1610 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2019 |
Last Update Date | 27/03/2019 |