Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 035687-1 | NY |
N | 2251G0304X | Physical Therapist - Geriatrics | 035687-1 | NY |
N | 2251N0400X | Physical Therapist - Neurology | 035687-1 | NY |
N | 2251S0007X | Physical Therapist - Sports | 035687-1 | NY |
NPI | 1750622957 |
---|---|
Provider Name | Dr. Gina Sarah Yaghoubi |
First Address | Eastchester, NY 10709-3815 |
Second Address | Yonkers, NY 10710-1856 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2013 |
Last Update Date | 15/02/2017 |