Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 12586 | CT |
NPI | 1063097392 |
---|---|
Provider Name | Emil Eugene Franz Gabuya |
First Address | Amawalk, NY 10501-1216 |
Second Address | Danbury, CT 06810-5945 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2021 |
Last Update Date | 07/04/2021 |