Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 017622-1 | NY |
NPI | 1063664324 |
---|---|
Provider Name | Dianna Lynn Palmisano |
First Address | Cortlandt Manor, NY 10567-6500 |
Second Address | Cortlandt Manor, NY 10567-6500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2008 |
Last Update Date | 21/10/2008 |