Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 039342 | NY |
N | 2251N0400X | Physical Therapist - Neurology | 039342 | NY |
N | 2251X0800X | Physical Therapist - Orthopedic | 039342 | NY |
NPI | 1528583655 |
---|---|
Provider Name | Joseph Thilman |
First Address | Woodside, NY 11377-3920 |
Second Address | Oceanside, NY 11572-1404 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2017 |
Last Update Date | 09/08/2017 |