Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 015322 | NY |
NPI | 1003216706 |
---|---|
Provider Name | Wendy Tse |
First Address | Flushing, NY 11355 |
Second Address | Flushing, NY 11355-4711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2014 |
Last Update Date | 26/06/2017 |