Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251N0400X | Physical Therapist - Neurology | 021528 | NY |
Y | 2251P0200X | Physical Therapist - Pediatrics | 021528 | NY |
NPI | 1689947814 |
---|---|
Provider Name | Amy Grasso |
First Address | Amherst, NY 14221-3757 |
Second Address | Amherst, NY 14221-3757 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2012 |
Last Update Date | 19/02/2012 |