Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 032209 | NY |
NPI | 1659690402 |
---|---|
Provider Name | George Ian Yu Namoc |
First Address | New York, NY 10016-5424 |
Second Address | New York, NY 10016-5424 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2010 |
Last Update Date | 09/10/2013 |