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NPI Code Detail

MEDICARE: AIMEE BETH TARGOVNIK OTR/L

MEDICARE:   AIMEE BETH TARGOVNIK  OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XP0200XPediatric Occupational Therapist007336-1NY

General Provider Information

NPI Number : 1952555294
Entity Type Code : Individual
Provider Name (Legal Business Name) : AIMEE BETH TARGOVNIK OTR/L
Provider Business Mailing Address
First Line : 35 W 92ND ST
Second Line : APT. 9F
City : NEW YORK
State : NY
Zip : 10025-7639
Country : US
Telephone Number : 917-861-4212
Fax Number :
Provider Business Practice Location Address
First Line : 2465 BATHGATE AVE
Second Line :
City : BRONX
State : NY
Zip : 10458-5928
Country : US
Telephone Number : 718-367-5917
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2008
Last Update Date : 11/13/2008

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Directions to “ AIMEE BETH TARGOVNIK OTR/L” Practice Location

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