Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 045560 | NY |
N | 2251S0007X | Physical Therapist - Sports | 045560 | NY |
NPI | 1295369346 |
---|---|
Provider Name | Dr. Alexander Charles Geissbuhler |
First Address | Irvington, NY 10533-1560 |
Second Address | Irvington, NY 10533-1560 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2020 |
Last Update Date | 27/02/2020 |