Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 025574-1 | NY |
NPI | 1326271651 |
---|---|
Provider Name | Loreyn Gorospe |
First Address | Beacon, NY 12508-1559 |
Second Address | Beacon, NY 12508-1559 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2009 |
Last Update Date | 03/09/2009 |