Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT002935E | PA |
NPI | 1184092926 |
---|---|
Provider Name | Ellen G Kalikow |
First Address | Huntingdon Valley, PA 19006-7727 |
Second Address | Huntingdon Valley, PA 19006-7727 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/09/2015 |
Last Update Date | 10/09/2015 |