Most Relevant Information
Provider Data
NPI Number: | 1003555004 |
Provider Name: | JARED VICTOR VIRELLA COTA/L |
Entity Type: | Individual |
Taxonomy Code: | 224Z00000X |
Specialty: | Occupational Therapy Assistant |
License Number: | 011108 |
Most Important Dates
Enumeration Date: | 05/31/2022 |
Last Updated: | 05/31/2022 |
Provider Practice Location
49 MONTROSE AVE
BROOKLYN
NY
112062580
Practice Location Phone/Fax
Phone: | 7184733808 |
Fax: |
Provider Mailing Location
511 W 232ND ST APT E43
BRONX
NY
104633561
Provider Mailing Phone/Fax
Phone: | 6462218750 |
Fax: |