Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 026048-1 | NY |
NPI | 1316397953 |
---|---|
Provider Name | David Vogel |
First Address | New York, NY 10017-5949 |
Second Address | New York, NY 10017-5949 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2016 |
Last Update Date | 14/06/2016 |