Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 033648-1 | NY |
NPI | 1396027637 |
---|---|
Provider Name | Miss Sneha Khetawat |
First Address | Oswego, NY 13126-2104 |
Second Address | Oswego, NY 13126-2104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2011 |
Last Update Date | 13/09/2011 |