Ifetayo Khalila Blissett, OTR/L

NPI #1881081438 in Glendale, New York

Provider Information

NPI Number: 1881081438
Entity Type: Individual
Name: Ifetayo Khalila Blissett, OTR/L
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: OTR/L
Enumeration Date: Apr 22, 2015
Last Updated: Apr 22, 2015

Practice Location

Address: 7618 69TH PL
Address 2: 5E
City: Glendale
State: New York
ZIP Code: 11385-7134
Phone: (516) 578-3139

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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