Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | P84823 | NY |
NPI | 1003161878 |
---|---|
Provider Name | Mr. Andrew Cho |
First Address | Manhasset, NY 11030-1225 |
Second Address | Roosevelt, NY 11575-1845 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2012 |
Last Update Date | 18/07/2012 |