Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 029736 | NY |
NPI | 1376176693 |
---|---|
Provider Name | Dana Lotan |
First Address | New York, NY 10016-2708 |
Second Address | New York, NY 10016-2708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2020 |
Last Update Date | 14/02/2020 |