Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | 2000023731 |
NPI | 1053870444 |
---|---|
Provider Name | Daniella Pusateri |
First Address | Commack, NY 11725-2714 |
Second Address | Greenvale, NY 11548-1213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2019 |
Last Update Date | 15/03/2019 |