Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 028419-1 | NY |
N | 2251C2600X | Cardiopulmonary | 028419-1 | NY |
N | 2251G0304X | Physical Therapist - Geriatrics | 028419-1 | NY |
N | 2251N0400X | Physical Therapist - Neurology | 028419-1 | NY |
N | 2251S0007X | Physical Therapist - Sports | 028419-1 | NY |
N | 2251X0800X | Physical Therapist - Orthopedic | 028419-1 | NY |
NPI | 1396709044 |
---|---|
Provider Name | Elizabeth Pearl |
First Address | Plattsburgh, NY 12901-2832 |
Second Address | Plattsburgh, NY 12901-2832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/04/2006 |
Last Update Date | 02/01/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q22366 | (02) | DE |