Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 5501015374 | MI |
NPI | 1275834707 |
---|---|
Provider Name | Miss Tejaswini S Shinde |
First Address | Wexford, PA 15090-7827 |
Second Address | Wexford, PA 15090-7827 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2010 |
Last Update Date | 15/11/2010 |