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General NPI Number Information
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NPI Number | 1972813293
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Entity Type | Individual
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Provider Name | ALANNA FOGARTY
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Gender | Female
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Dates
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Enumeration Date | 10/20/2010
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Last Update Date | 10/20/2010
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Provider Practice Location Address
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Address Line | 4951 CHAMBERS STREET 6TH FLOOR
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City | NEW YORK
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State | NY
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Zip | 10007-1209
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Country | US
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Telephone | 347-552-7057
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Fax |
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Provider Business Mailing Address
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Address Line | 34-20 32ND STREET, APT. 3H
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City | ASTORIA
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State | NY
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Zip | 11106-2775
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Country | US
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Telephone | 347-552-7057
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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 | 015668
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License Number State | NY
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