Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251S0007X | Physical Therapist - Sports | ||
Y | 2251X0800X | Physical Therapist - Orthopedic |
NPI | 1306361779 |
---|---|
Provider Name | Lauren Walczewski |
First Address | Hastings On Hudson, NY 10706-3520 |
Second Address | Scarsdale, NY 10583-5316 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2017 |
Last Update Date | 07/08/2017 |