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General NPI Number Information
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NPI Number | 1962724930
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Entity Type | Individual
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Provider Name | MR. IAN PERRY
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Gender | Male
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Dates
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Enumeration Date | 02/18/2010
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Last Update Date | 02/18/2010
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Provider Practice Location Address
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Address Line | 624 E 220TH ST APT 2J
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City | BRONX
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State | NY
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Zip | 10467-5349
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Country | US
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Telephone | 646-321-3342
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Fax |
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Provider Business Mailing Address
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Address Line | 624 EAST 220TH STREET APT 2J
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City | BRONX
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State | NY
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Zip | 10469-5349
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Country | US
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Telephone | 646-321-3342
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 007549-1
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License Number State | OK
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