Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 006169 | NY |
Y | 222Z00000X | Podiatrist | 006169 | NY |
NPI | 1013097286 |
---|---|
Provider Name | Dr. Reesheman Genee Cowart |
First Address | Bronx, NY 10463-7503 |
Second Address | Bronx, NY 10463-7503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 27/07/2010 |