Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 008801-1 | NY |
NPI | 1154760122 |
---|---|
Provider Name | Jean L Minkel |
First Address | New Windsor, NY 12553-5921 |
Second Address | Brooklyn, NY 11201-5355 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2013 |
Last Update Date | 22/06/2013 |