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General NPI Number Information
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NPI Number | 1487866323
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Entity Type | Individual
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Provider Name | DREW BENNETT ELMORE OTR
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Gender | Male
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3909 214TH PL
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City | BAYSIDE
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State | NY
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Zip | 11361-2123
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Country | US
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Telephone | 718-229-5757
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Fax |
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Provider Business Mailing Address
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Address Line | 2312 CROYDON DR
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City | BALDWIN
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State | NY
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Zip | 11510-3022
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Country | US
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Telephone | 516-546-6206
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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 | 005962-1
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License Number State | NY
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