Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant |
NPI | 1003575895 |
---|---|
Provider Name | Dania Legros |
First Address | Melville, NY 11747-5002 |
Second Address | Hartsdale, NY 10530-1951 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2021 |
Last Update Date | 09/12/2021 |