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General NPI Number Information
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NPI Number | 1104182666
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Entity Type | Individual
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Provider Name | USHA RAGHAVAN M.A; M.S.
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Gender | Female
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Dates
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Enumeration Date | 04/09/2012
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Last Update Date | 04/09/2012
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Provider Practice Location Address
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Address Line | 132 W.89TH STREET PS. 166
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City | NEW YORK
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State | NY
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Zip | 10024
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Country | US
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Telephone | 212-678-2828
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Fax |
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Provider Business Mailing Address
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Address Line | 5A OLDE WILLOW WAY
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City | BRIARCLIFF MANOR
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State | NY
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Zip | 10510-1452
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Country | US
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Telephone | 914-923-9711
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 008758
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License Number State | NY
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