Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 011251-1 | NY |
NPI | 1003958695 |
---|---|
Provider Name | Victoria Lingen |
First Address | East Norwich, NY 11732-1416 |
Second Address | Syosset, NY 11791-4022 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2007 |
Last Update Date | 08/07/2007 |