Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 123420 | NY |
NPI | 1053558585 |
---|---|
Provider Name | Miss Kathleen Rebecca Watson |
First Address | Brooklyn, NY 11217-2410 |
Second Address | Brooklyn, NY 11217-2410 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/01/2009 |
Last Update Date | 21/01/2009 |