Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | 025791-01 | NY |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 025791-01 | NY |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 025791-01 | NY |
NPI | 1477221802 |
---|---|
Provider Name | Tania Maribel Puchuela |
First Address | Corona, NY 11368-1324 |
Second Address | Bronx, NY 10465-1606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2021 |
Last Update Date | 31/08/2021 |