Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 024539 | NY |
NPI | 1073767661 |
---|---|
Provider Name | Miss Arlen Rosales Mendoza |
First Address | Yonkers, NY 10704-2050 |
Second Address | Bronx, NY 10469-5915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2008 |
Last Update Date | 09/11/2008 |