Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225700000X | Massage Therapist | 27 028490 | NY |
Y | 226300000X | Kinesiotherapist | 27 028490 | NY |
NPI | 1083018816 |
---|---|
Provider Name | Brooke H Neufeld |
First Address | Oceanside, NY 11572-5101 |
Second Address | Oceanside, NY 11572-5101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2014 |
Last Update Date | 22/10/2014 |