Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 021803-1 | NY |
NPI | 1235648395 |
---|---|
Provider Name | William L Jim |
First Address | Elmhurst, NY 11373-4102 |
Second Address | New York, NY 10013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2017 |
Last Update Date | 28/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05103177 | (05) | NY |