Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 009456-1 | NY |
NPI | 1053557835 |
---|---|
Provider Name | Joan Rachelle Katz |
First Address | Brooklyn, NY 11230-1713 |
Second Address | Brooklyn, NY 11230-1713 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/12/2008 |
Last Update Date | 27/12/2008 |