Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 843598345 | NY |
NPI | 1033439682 |
---|---|
Provider Name | Miss Rebekah Yen Yen Tho |
First Address | Seneca Falls, NY 13148-1575 |
Second Address | Seneca Falls, NY 13148-1575 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/06/2010 |
Last Update Date | 06/06/2010 |