Provider Demographics
NPI:1831400241
Name:PUNSALAN, JOANNE FLORES (OT/L)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:FLORES
Last Name:PUNSALAN
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4712 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-1332
Mailing Address - Country:US
Mailing Address - Phone:347-559-9248
Mailing Address - Fax:
Practice Address - Street 1:4712 21ST AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-1332
Practice Address - Country:US
Practice Address - Phone:347-559-9248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015571-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist