Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 008469 | CT |
NPI | 1245460583 |
---|---|
Provider Name | Miss Shirine Patrisha Dabiri |
First Address | Longmeadow, MA 01106-2822 |
Second Address | Rocky Hill, CT 06067-3518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2009 |
Last Update Date | 21/07/2009 |