Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 036686-1 | NY |
NPI | 1053739789 |
---|---|
Provider Name | Alexander Schieck |
First Address | Garden City, NY 11530-1910 |
Second Address | Manhasset, NY 11030-3006 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2014 |
Last Update Date | 31/03/2014 |