Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 028840-1 | NY |
N | 2251P0200X | Physical Therapist - Pediatrics | 0288401 | NY |
NPI | 1013153287 |
---|---|
Provider Name | Basya Schwab |
First Address | Suffern, NY 10901-1507 |
Second Address | Monsey, NY 10952-2852 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/12/2008 |
Last Update Date | 30/04/2010 |