Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 023830 | NY |
N | 2251N0400X | Physical Therapist - Neurology | 023830 | NY |
NPI | 1336268697 |
---|---|
Provider Name | Keri Elyse Fisher |
First Address | Brooklyn, NY 11215-6833 |
Second Address | Brooklyn, NY 11215-6833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2007 |
Last Update Date | 29/11/2020 |