Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251E1200X | Ergonomics | 019999 | NY |
Y | 225XE1200X | Ergonomics | 019999 | NY |
NPI | 1861860207 |
---|---|
Provider Name | Melysa Tekla Markut |
First Address | Kew Gardens, NY 11415-2210 |
Second Address | Kew Gardens, NY 11415-2210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/09/2015 |
Last Update Date | 20/11/2015 |