Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 031589 | NY |
NPI | 1043846355 |
---|---|
Provider Name | Cheryl Damilatis |
First Address | White Plains, NY 10606-7004 |
Second Address | Scarsdale, NY 10583-1038 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/03/2020 |
Last Update Date | 18/03/2020 |