Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 028801 | NY |
NPI | 1659911451 |
---|---|
Provider Name | Jennifer Fay |
First Address | New York, NY 10016-2708 |
Second Address | New York, NY 10016-2708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2020 |
Last Update Date | 09/01/2020 |