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General NPI Number Information
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NPI Number | 1821229469
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Entity Type | Individual
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Provider Name | GLEN JOSEPH SANTACROCE OTR/L, CHT
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Gender | Male
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Dates
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Enumeration Date | 07/30/2009
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Last Update Date | 11/06/2014
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Provider Practice Location Address
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Address Line | 115 MAIN ST SUITE 202 2ND FLOOR
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City | TUCKAHOE
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State | NY
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Zip | 10707-2948
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Country | US
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Telephone | 914-961-1010
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Fax | 914-961-1011
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Provider Business Mailing Address
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Address Line | 115 MAIN ST SUITE 202 2ND FLOOR
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City | TUCKAHOE
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State | NY
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Zip | 10707-2948
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Country | US
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Telephone | 914-961-1010
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Fax | 914-961-1011
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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 | 009374-1
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License Number State | NY
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