Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 014002-1 | NY |
NPI | 1073770517 |
---|---|
Provider Name | Ma Girlie Acero |
First Address | Floral Park, NY 11001-1704 |
Second Address | Floral Park, NY 11001-1704 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2008 |
Last Update Date | 02/01/2013 |