Ambryel Marie Moder
NPI #1124546155 in Middle Island, New York
Provider Information
- NPI Number
- 1124546155
- Entity Type
- Individual
- Name
- Ambryel Marie Moder
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Occupational Therapist
- Enumeration Date
- Aug 30, 2017
- Last Updated
- Mar 17, 2018
Practice Location
- Address
- 35 LONGWOOD RD
- City
- Middle Island
- State
- New York
- ZIP Code
- 11953-2045
- Phone
- (631) 924-0008
Specialties & Taxonomy Codes
| Specialty |
|---|
| Occupational Therapist |
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