Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 025289 | NY |
NPI | 1033358353 |
---|---|
Provider Name | Mr. Anthony Tan Lim |
First Address | New Rochelle, NY 10805-3626 |
Second Address | New Rochelle, NY 10805-3626 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2009 |
Last Update Date | 10/02/2009 |