Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 035178 | NY |
NPI | 1003346198 |
---|---|
Provider Name | Dr. Terrence O'grady |
First Address | Garden City, NY 11530-6109 |
Second Address | Garden City, NY 11530-5942 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2017 |
Last Update Date | 13/06/2017 |