Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 27246 | NY |
Y | 2251P0200X | Physical Therapist - Pediatrics | 27246 | NY |
NPI | 1134495161 |
---|---|
Provider Name | Eduard Kho |
First Address | Bronx, NY 10459-3703 |
Second Address | Bronx, NY 10459-3703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2012 |
Last Update Date | 23/03/2012 |