Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports |
NPI | 1215573597 |
---|---|
Provider Name | Kayla Bendul |
First Address | Woodcliff Lake, NJ 07677-8091 |
Second Address | Woodcliff Lake, NJ 07677 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2019 |
Last Update Date | 21/11/2019 |