Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 027265 | NY |
NPI | 1013310275 |
---|---|
Provider Name | Elaine Drucker |
First Address | Glasco, NY 12432 |
Second Address | Glasco, NY 12432 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2014 |
Last Update Date | 02/10/2014 |