Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 037151 | NY |
NPI | 1073943460 |
---|---|
Provider Name | Miss Nicole Elizabeth Greenberg |
First Address | White Plains, NY 10605-1830 |
Second Address | White Plains, NY 10605-1830 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2013 |
Last Update Date | 21/11/2013 |