Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 037896 | NY |
NPI | 1063812998 |
---|---|
Provider Name | Camron M Einerman |
First Address | Bay Shore, NY 11706-5319 |
Second Address | Bay Shore, NY 11706-5319 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2014 |
Last Update Date | 10/09/2014 |