Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 129950-1 | NY |
Y | 2251P0200X | Physical Therapist - Pediatrics | 029950-1 | NY |
NPI | 1093969131 |
---|---|
Provider Name | Diana Lomonte |
First Address | Fresh Meadows, NY 11365-3973 |
Second Address | Brooklyn, NY 11211-1415 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2008 |
Last Update Date | 08/09/2010 |