Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 038208-1 | NY |
NPI | 1003219585 |
---|---|
Provider Name | Caitlin Bedell |
First Address | New York, NY 10023-3300 |
Second Address | New York, NY 10023-3300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2014 |
Last Update Date | 29/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
208311672 | (05) | NY |