Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 003183-1 | NY |
NPI | 1326325267 |
---|---|
Provider Name | Marion Tobi Worenklein |
First Address | New York, NY 10025-3445 |
Second Address | New York, NY 10025-3445 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2011 |
Last Update Date | 07/11/2011 |